Healthcare Provider Details

I. General information

NPI: 1619406477
Provider Name (Legal Business Name): DAHLIA JAFFER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7773 UNIVERSITY AVE
LA MESA CA
91942-4950
US

IV. Provider business mailing address

1528 SUMMIT AVE
CARDIFF BY THE SEA CA
92007-2434
US

V. Phone/Fax

Practice location:
  • Phone: 760-741-1344
  • Fax:
Mailing address:
  • Phone: 951-500-6084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number66509
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number4690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: