Provider Demographics
NPI:1356439939
Name:RELDAN, JANE (M D)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:RELDAN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2368
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92038-2368
Mailing Address - Country:US
Mailing Address - Phone:858-459-6600
Mailing Address - Fax:858-459-6605
Practice Address - Street 1:467 COAST BOULEVARD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-459-6600
Practice Address - Fax:858-459-6605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine