Provider Demographics
NPI:1487648929
Name:AFABLE, JESSICA G (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:G
Last Name:AFABLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 N. EL CIELO
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-323-8657
Mailing Address - Fax:760-318-9083
Practice Address - Street 1:275 N EL CIELO
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-323-8657
Practice Address - Fax:760-318-9083
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A625340Medicare PIN
CAG41017Medicare UPIN