Jamal Jon Derakhshan
Medical Specialty
Professional ID
- NPI: 1134410426
- PECOS ID: 6709182751
- Enrollment ID: I20170607001262
- Credential(MD, DO, DPM):
- Medical School: Case Western Reserve University School Of Medicine
- Medical School Graduation Year: 2011
Hospital Service
- Hospital CCN1: 390111
- Business Name (LBN)1: Hospital Of Univ Of Pennsylvania
- Hospital CCN2: 390223
- Business Name (LBN)2: Penn Presbyterian Medical Center
- Hospital CCN3: 390226
- Business Name (LBN)3: Pennsylvania Hospital
Medical Practices
- Organization Name: University Of Penn Medical Group
- Group Practice ID assigned by PECOS: 6204730955
- Number of Group Practice member: 2279
Location
- Address1: 3400 Spruce St
- Address2: Department Of Radiology
- City: Philadelphia
- State: Pennsylvania
- Zip Code: 19104
- Phone Number: (215)662-3000
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):