MEDICARE: JEFFREY I. GORWIT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	G25365	CA
2	207RC0000X	Cardiovascular Disease Physician	G25365	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	GQ547Z	OTHER	CA	MEDICARE
3	P01123966	OTHER	CA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891798658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY I. GORWIT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 28199
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92198-0199
Country	:	US
Telephone Number	:	858-673-2574
Fax Number	:	858-618-1523

Provider Business Practice Location Address
First Line	:	1955 CITRACADO PKWY STE 300
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92029-4113
Country	:	US
Telephone Number	:	760-743-0546
Fax Number	:	760-743-8837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/08/2018

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Directions to “ JEFFREY I. GORWIT M.D.” Practice Location

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