Provider Demographics
NPI:1225025422
Name:JAFFER, A KAREEM (MD)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:KAREEM
Last Name:JAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1011 E DEVONSHIRE AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3033
Mailing Address - Country:US
Mailing Address - Phone:951-658-2218
Mailing Address - Fax:951-765-9126
Practice Address - Street 1:1011 E DEVONSHIRE AVE
Practice Address - Street 2:STE 102
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3033
Practice Address - Country:US
Practice Address - Phone:951-658-2218
Practice Address - Fax:951-765-9126
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA336262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A336260Medicaid
A87902Medicare UPIN
CA00A336260Medicare ID - Type Unspecified