Healthcare Provider Details

I. General information

NPI: 1023137486
Provider Name (Legal Business Name): SUHAIL M JAFREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1582 W SAN MARCOS BLVD STE 100
SAN MARCOS CA
92078-4081
US

IV. Provider business mailing address

3830 VALLEY CENTRE DR STE 705-832
SAN DIEGO CA
92130-3320
US

V. Phone/Fax

Practice location:
  • Phone: 442-222-1514
  • Fax: 949-841-1591
Mailing address:
  • Phone: 442-222-1514
  • Fax: 858-400-4332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC142492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: