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General NPI Number Information
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NPI Number | 1396279113
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Entity Type | Organization
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Legal Business Name | DR JAISWALS MEDICAL CENTER PC
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 17424 ASHBURTON RD
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City | SAN DIEGO
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State | CA
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Zip | 92128-3937
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Country | US
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Telephone | 734-757-0244
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Fax |
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Provider Business Mailing Address
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Address Line | 5222 BALBOA AVE STE 45
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City | SAN DIEGO
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State | CA
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Zip | 92117-6941
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Country | US
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Telephone | 858-616-6430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASHWANI JAISWAL
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Credential | MD
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Telephone | 734-757-0244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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