MEDICARE: FERESHTEH JAHANPANAH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G65104	CA
2	207R00000X	Internal Medicine Physician	G65104	CA

General Provider Information

NPI Number	:	1518034115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERESHTEH JAHANPANAH MD

Provider Business Mailing Address
First Line	:	PO BOX 1626
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92022-1622
Country	:	US
Telephone Number	:	619-447-6001
Fax Number	:	619-447-6096

Provider Business Practice Location Address
First Line	:	343 E MAIN ST STE 101
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3942
Country	:	US
Telephone Number	:	619-447-6001
Fax Number	:	619-447-6096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	04/25/2025

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