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Individual

ANITA JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(707) 864-5383
(707) 399-2651
Mailing address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(707) 864-5383
(707) 399-2651

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A76657
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A76657
MEDICAL LICENSE
CA
Enumeration date
09/16/2006
Last updated
07/09/2007
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