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General NPI Number Information
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NPI Number | 1992847263
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Entity Type | Individual
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Provider Name | ROULA SOUFI ADJAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 7695 CARDINAL CT STE 370
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City | SAN DIEGO
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State | CA
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Zip | 92123-3332
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Country | US
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Telephone | 619-865-6479
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Fax |
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Provider Business Mailing Address
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Address Line | 10785 CALLE MAR DE MARIPOSA
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City | SAN DIEGO
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State | CA
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Zip | 92130-8656
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Country | US
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Telephone | 619-865-6479
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A81682
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License Number State | CA
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