KIRAN A JAIN


Address: 1213 Southfield Ct, Davis, CA 95616-5727
Phone: 9525951100

KIRAN A JAIN (NPI# 1750369336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750369336
Entity Type Individual
Full Name KIRAN A JAIN
Credential M.D.
Practice Address 1213 Southfield Ct
Davis
CA 95616-5727
Mailing Address 11995 Singletree Ln
Ste 500
Eden Prairie
MN 55344-5347
Practice Telephone 9525951100
Practice Fax Number 6122944903
Mailing Telephone 9525951301
Mailing Fax Number 6122944903
Enumeration Date 2006-01-04
Last Update Date 2019-12-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
A44854 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA FEDERAL DEA LICENSE FJ4864559 01
CA STATE MEDICAL LICENSE A44854 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3883 Airway Dr Ste 100, Santa Rosa, CA 954031672 7075214480 7075214460

Office Location

Street Address 1213 SOUTHFIELD CT
City DAVIS
State CA
Zip Code 95616-5727

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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578075263 Solano Diagnostics Partners, A Calif Limited Partnership Radiology 1810 Oceano Way, Davis, CA 95618-6768 2017-11-02
1043452659 Christopher George Wladyka Radiology 2124 Rockwell Dr, Davis, CA 95618-7614 2009-03-27
1740368588 John C. Ling Radiology 1527 Arena Dr, Davis, CA 95618-6749 2006-11-01
1023129855 Steven E Liston Radiology 1562 Rialto Ln, Davis, CA 95618-6401 2006-08-31
1043722739 Quantum Medical Radiology of California, P.C. Radiology 1810 Oceano Way, Davis, CA 95618-6768 2017-11-02

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Competitor

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City DAVIS
Zip Code 95616

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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