Active NPI
Howard Jaffe, M.D.
- Corporate Health Clinic/Center
- Mill Valley, CA
National Provider Identifier
1174876726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corporate Health Clinic/Center
- License
- G51582
- Practice address
- 22 Eugene St
Mill Valley, CA 94941-1718 - Phone
- (650) 522-5702
- NPI assigned
- Oct 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corporate Health Clinic/Center | 261QC1800X | G51582 | CA | Primary |
Addresses
Primary practice location
22 Eugene St
Mill Valley, CA 94941-1718
Mailing address
22 Eugene St
Mill Valley, CA 94941-1718
Phone (650) 522-5702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G51582 | CA | MD | Corporate Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350604800000",
"number": "1174876726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 EUGENE ST",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949411718",
"telephone_number": "650-522-5702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 EUGENE ST",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949411718",
"telephone_number": "650-522-5702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "HOWARD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-19",
"last_updated": "2012-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "261QC1800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Corporate Health",
"state": "CA",
"license": "G51582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.