Healthcare Provider Details
I. General information
NPI: 1194046581
Provider Name (Legal Business Name): ANUJA VORA JINDAL MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/20/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8001 FROST ST
SAN DIEGO CA
92123-2746
US
IV. Provider business mailing address
3020 CHILDRENS WAY # MC5003
SAN DIEGO CA
92123-4223
US
V. Phone/Fax
- Phone: 858-966-5819
- Fax:
- Phone: 858-309-6300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A149444 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0402X |
| Taxonomy | Neurology with Special Qualifications in Child Neurology Physician |
| License Number | A149444 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0005X |
| Taxonomy | Neurodevelopmental Disabilities Physician |
| License Number | A149444 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: