Healthcare Provider Details

I. General information

NPI: 1033441316
Provider Name (Legal Business Name): SETAREH SAFII JONES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W MAIN ST
EL CAJON CA
92020
US

IV. Provider business mailing address

133 W MAIN ST
EL CAJON CA
92020-3315
US

V. Phone/Fax

Practice location:
  • Phone: 619-401-0404
  • Fax: 619-401-0522
Mailing address:
  • Phone: 619-401-0404
  • Fax: 619-401-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA110010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: