Healthcare Provider Details

I. General information

NPI: 1891213245
Provider Name (Legal Business Name): RISHI JINDAL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6386 ALVARADO CT STE 330
SAN DIEGO CA
92120-4908
US

IV. Provider business mailing address

6386 ALVARADO CT STE 330
SAN DIEGO CA
92120-4908
US

V. Phone/Fax

Practice location:
  • Phone: 619-286-6446
  • Fax: 619-286-1618
Mailing address:
  • Phone: 619-286-6446
  • Fax: 619-286-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA149221
License Number StateCA

VIII. Authorized Official

Name: DR. RISHI JINDAL
Title or Position: OWNER
Credential: MD
Phone: 909-374-0231