Provider Demographics
NPI:1093787889
Name:CAVENDISH, JEFFREY JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:CAVENDISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8282 TORREY PARK TER
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4623
Mailing Address - Country:US
Mailing Address - Phone:858-538-0840
Mailing Address - Fax:
Practice Address - Street 1:34730 BOB WILSON DR
Practice Address - Street 2:CARDIOLOGY, SUITE 303 NAVAL MEDICAL CENTER SAN DIEGO
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3098
Practice Address - Country:US
Practice Address - Phone:619-532-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83079207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology