Individual
JACK MARTIN PERCELAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G66425
CA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MA07157000
NJ
208M00000X
Hospitalist Physician
Primary
G66425
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028371
—
NJ
Enumeration date
10/31/2005
Last updated
04/28/2024
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