Healthcare Provider Details
I. General information
NPI: 1285349308
Provider Name (Legal Business Name): KARIMEE G JARAMILLO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
MARIA 402-6 BEATRIZ BENITO JUAREZ
MEXICALI BC
21280
MX
IV. Provider business mailing address
4275 EXECUTIVE SQ STE 302
LA JOLLA CA
92037-9123
US
V. Phone/Fax
- Phone: 619-488-3200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KARIMEE
G
JARAMILLO
Title or Position: DENTIST
Credential: DDS
Phone: 619-488-3200