Healthcare Provider Details

I. General information

NPI: 1629994074
Provider Name (Legal Business Name): JTJSK PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 15TH ST
SAN DIEGO CA
92101
US

IV. Provider business mailing address

542 15TH ST
SAN DIEGO CA
92101-7536
US

V. Phone/Fax

Practice location:
  • Phone: 619-489-3478
  • Fax:
Mailing address:
  • Phone:
  • Fax: 888-676-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASPREET SOMAL
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MD
Phone: 619-489-3478