=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851223879
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFERS CHIROPRACTIC AND SPORTS INJURIES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2026
-----------------------------------------------------
Last Update Date | 06/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7770 REGENTS RD STE 105
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92122-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-452-7770
-----------------------------------------------------
Fax | 858-452-0027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7770 REGENTS RD STE 105
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92122-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-452-7770
-----------------------------------------------------
Fax | 858-452-0027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIOROPRACTIC
-----------------------------------------------------
Name | SCOTT ROBERT JEFFERS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 858-452-7770
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------