Colin X Jairam MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A101534 Issued in CA

Legal business name

COLIN X JAIRAM MD INC

Practice address

1031 Avenida Pico
Sutie 103
San Clemente, CA 92673-6352

Phone

(202) 904-8490

NPI assigned

May 16, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Colin Xephary Jairam, M.D.

Title

President

Phone

(949) 429-1919

Specialties & licenses 1

Addresses

Other names 1

• Hybrid MD Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1093126609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 AVENIDA PICO",
            "address_2": "SUTIE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736352",
            "telephone_number": "949-429-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 AVENIDA PICO",
            "address_2": "SUTIE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736352",
            "telephone_number": "202-904-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIN X JAIRAM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "JAIRAM",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "XEPHARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-429-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hybrid MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.