Provider Demographics
NPI:1447089933
Name:JANG, JASON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:JANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:HOANG
Other - Middle Name:HON
Other - Last Name:DAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HARRIET AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-2927
Mailing Address - Country:US
Mailing Address - Phone:408-515-2647
Mailing Address - Fax:
Practice Address - Street 1:5630 COTTLE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3696
Practice Address - Country:US
Practice Address - Phone:408-600-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH89661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist