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General NPI Number Information
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NPI Number | 1316705486
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Entity Type | Organization
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Legal Business Name | JAY'S HEART
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 7660-H FAY AVE #154
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-531-7216
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Fax |
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Provider Business Mailing Address
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Address Line | 7660-H FAY AVE #154
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-531-7216
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DIANE WINTZ
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Credential |
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Telephone | 858-531-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Surgery) Physician
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License Number |
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License Number State |
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