Individual provider Active NPI

Alan Nmi Jarach, MD

  • General Practice Physician
  • San Rafael, CA
National Provider Identifier
1780940536
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G11450 Issued in CA
Practice address
83 Sunny Oaks Dr
San Rafael, CA 94903-3084
Phone
(415) 479-5132
Fax
(415) 000-0000
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G11450 CA Primary

Addresses

Primary practice location

83 Sunny Oaks Dr
San Rafael, CA 94903-3084

Mailing address

83 Sunny Oaks Dr
San Rafael, CA 94903-3084
Phone (415) 479-5132

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

LicenseStateTypeSpecialty
G11450CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1780940536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SUNNY OAKS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033084",
            "telephone_number": "415-479-5132",
            "fax_number": "415-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SUNNY OAKS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033084",
            "telephone_number": "415-479-5132",
            "fax_number": "415-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARACH",
        "first_name": "ALAN",
        "middle_name": "NMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G11450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.