Individual ProviderJai UttamAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address170 Alameda De Las Pulgas, Redwood City, CA 94062-2751(559) 459-6000(559) 375-3340PECOS EnrollmentBased on the most recent information from CMS, provider Jai Uttam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1740212703Provider TypeIndividualFull NameUttam, JaiTitleMr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/7/2006Last Updated10/30/2015Contact InformationPractice LocationPractice Address170 Alameda De Las Pulgas, Redwood City, CA 94062-2751Phone(559) 459-6000Fax(650) 367-5230Mailing LocationMailing Address2210 Hastings Dr, Apt 209, Belmont, CA 94002-3373Phone(559) 375-3340Fax(650) 367-5230Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseA84812CaliforniaProvider IdentifiersIDDescriptionIssuerID00A848120DescriptionOtherIssuerBLUE SHIELD OF CALIFORNIACaliforniaID00A848120DescriptionMedicaidIssuerUnlistedCalifornia