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General NPI Number Information
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NPI Number | 1558777490
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Entity Type | Organization
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Legal Business Name | JENNIFER JOTHEN, D.O., A.P.C.
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 752 MEDICAL CENTER CT STE 210
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City | CHULA VISTA
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State | CA
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Zip | 91911-6660
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Country | US
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Telephone | 619-656-0206
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 181337
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City | CORONADO
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State | CA
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Zip | 92178-1337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER JOTHEN
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Credential | D.O.
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Telephone | 215-837-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 20A10603
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License Number State | CA
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