Healthcare Provider Details

I. General information

NPI: 1962339978
Provider Name (Legal Business Name): NANCY JEANNE BINKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 GILMAN DR
LA JOLLA CA
92093-5004
US

IV. Provider business mailing address

4609 NORMA DR
SAN DIEGO CA
92115-3134
US

V. Phone/Fax

Practice location:
  • Phone: 760-888-7014
  • Fax: 760-888-7014
Mailing address:
  • Phone: 760-888-7014
  • Fax: 760-888-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG33852
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: