Healthcare Provider Details

I. General information

NPI: 1619293909
Provider Name (Legal Business Name): RISHI JINDAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
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 TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberA149221
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberA149221
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA149221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: