Individual
BHAWNA JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 SIR FRANCIS DRAKE BLVD, KENTFIELD, CA 94904-1418
(415) 485-3524
(415) 485-3507
Mailing address
30166 INDUSTRIAL PKWY SW, #272, HAYWARD, CA 94544-6906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A68306
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A68306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A68306
PPIN
CA
Enumeration date
04/06/2007
Last updated
02/23/2010
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