| Jc Aljammal Pllc | |
|
4465 S 900 E Ste 200 Salt Lake City UT 84124-2695 | |
| (412) 996-0131 | |
| (801) 683-6845 |
| Full Name | Jc Aljammal Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4465 S 900 E Ste 200, Salt Lake City, Utah |
| Authorized Official Name and Position | Laura John (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8012316986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jc Aljammal Pllc Po Box 520247 Salt Lake City UT 84152-0247 Ph: (412) 996-0131 | Jc Aljammal Pllc 4465 S 900 E Ste 200 Salt Lake City UT 84124-2695 Ph: (412) 996-0131 |
| NPI Number | 1710466115 |
|---|---|
| Provider Enumeration Date | 08/07/2018 |
| Last Update Date | 07/17/2019 |
| Medicare PECOS PAC ID | 6103154570 |
|---|---|
| Medicare Enrollment ID | O20190822002733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710466115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jules Aljammal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1083846018 PECOS PAC ID: 2769606193 Enrollment ID: I20140605000132 |
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