Nam, Jerry I

Nam, Jerry I is an individual health care provider with primary practice located at 4445 Magnolia Ave , Riverside CA 92501-4135. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Nam, Jerry I can be contacted via phone (951) 788-3400.

Contact Information

Primary practice address
4445 Magnolia Ave Riverside CA 92501-4135
Phone: (951) 788-3400
Fax: (979) 774-7871
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X J6616 Texas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X J6616 Texas
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X A65698 California

Profile Details

NPI number 1972565000
LBN Legal business name Nam, Jerry I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jun 13th, 2024 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972565000 NPPES
Texas MEDICAID 118679302

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