Provider Demographics
NPI:1285830505
Name:JAMISON, KAREN HERBST (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:HERBST
Last Name:JAMISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ALIDA
Other - Last Name:HERBST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4060 FOURTH AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2116
Mailing Address - Country:US
Mailing Address - Phone:619-298-1318
Mailing Address - Fax:619-298-0843
Practice Address - Street 1:4060 FOURTH AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2116
Practice Address - Country:US
Practice Address - Phone:619-298-1318
Practice Address - Fax:619-298-0843
Is Sole Proprietor?:No
Enumeration Date:2007-06-24
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A953560Medicaid
CA1912003252OtherHILLCREST INTERNAL MEDICINE GROUP NPI NUMBER
CAWA95356AOtherMEDICARE PIN LINKED WITH SD HOSPITAL BASED PHYSICIANS MED ASSN