Provider Demographics
NPI:1487694931
Name:JAIN, UDAY (MD)
Entity type:Individual
Prefix:MR
First Name:UDAY
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CHATEAU DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-6501
Mailing Address - Country:US
Mailing Address - Phone:650-430-0017
Mailing Address - Fax:650-348-6866
Practice Address - Street 1:2222 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2904
Practice Address - Country:US
Practice Address - Phone:408-988-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71152207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G711520OtherBS OF CA
CA00G711520Medicaid
CA00G711520OtherBS OF CA
CA00G711520Medicare ID - Type Unspecified