Healthcare Provider Details

I. General information

NPI: 1851223879
Provider Name (Legal Business Name): JEFFERS CHIROPRACTIC AND SPORTS INJURIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7770 REGENTS RD STE 105
SAN DIEGO CA
92122-1937
US

IV. Provider business mailing address

7770 REGENTS RD STE 105
SAN DIEGO CA
92122-1937
US

V. Phone/Fax

Practice location:
  • Phone: 858-452-7770
  • Fax: 858-452-0027
Mailing address:
  • Phone: 858-452-7770
  • Fax: 858-452-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KEITH MICHAEL JEFFERS
Title or Position: DOCTOR OF CHIOROPRACTIC
Credential: DC
Phone: 858-452-7770