Healthcare Provider Details

I. General information

NPI: 1548417751
Provider Name (Legal Business Name): GHAFAR NAFES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 2ND AVE STE. 101
ESCONDIDO CA
92025-4212
US

IV. Provider business mailing address

1630 E MAIN ST
EL CAJON CA
92021-5204
US

V. Phone/Fax

Practice location:
  • Phone: 760-291-6700
  • Fax: 760-738-9047
Mailing address:
  • Phone: 800-290-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA104813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: