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DR. JARED NIKOLAUS GARRISON-JAKEL MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1962728550
Individual Registrant:DR. JARED NIKOLAUS GARRISON-JAKEL MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
16319 THIRD STREET GUERNEVILLE, CA 95446 US
Tel: 707-869-2849 Fax: 707-869-5983
Tel: 707-869-2849 Fax: 707-869-5983
Contact information for business:
PO BOX 1449 GUERNEVILLE, CA 95446-1449 US
Tel: 707-869-5977 Fax: 707-869-5983
Tel: 707-869-5977 Fax: 707-869-5983
Registration Information:
NPI: 1962728550
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | CA | A117594 |
| N | 390200000X | Student Organized Health Care Education/Training Program |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1356344758 | CA | 05 |
