Healthcare Provider Details

I. General information

NPI: 1275791477
Provider Name (Legal Business Name): NEHA JAIN SAMPATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NEHA JAIN

II. Dates (important events)

Enumeration Date: 05/26/2008
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6354 MONTEZ VILLA RD
SAN DIEGO CA
92130-5788
US

IV. Provider business mailing address

6354 MONTEZ VILLA RD
SAN DIEGO CA
92130-5788
US

V. Phone/Fax

Practice location:
  • Phone: 858-752-4588
  • Fax:
Mailing address:
  • Phone: 858-752-4588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA105989
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA105989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: