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General NPI Number Information
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NPI Number | 1033433008
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Entity Type | Individual
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Provider Name | JENNIFER DOLMAJIAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 4647 ZION AVE
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City | SAN DIEGO
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State | CA
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Zip | 92120-2507
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Country | US
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Telephone | 619-528-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5340 TOSCANA WAY F210
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City | SAN DIEGO
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State | CA
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Zip | 92122-5671
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Country | US
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Telephone | 858-412-3354
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Fax | 858-412-3354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A111030
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License Number State | CA
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