Provider Demographics
NPI:1487842985
Name:JMS MEDICAL, INC.
Entity Type:Organization
Organization Name:JMS MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-632-5456
Mailing Address - Street 1:2227-B EL CAMINO REAL
Mailing Address - Street 2:MISSION DIALYSIS CENTER OF OCEANSIDE
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054
Mailing Address - Country:US
Mailing Address - Phone:760-757-1838
Mailing Address - Fax:760-757-6693
Practice Address - Street 1:2227-B EL CAMINO REAL
Practice Address - Street 2:MISSION DIALYSIS CENTER OF OCEANSIDE
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054
Practice Address - Country:US
Practice Address - Phone:760-757-1838
Practice Address - Fax:760-757-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95882207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1255394789OtherNPI-PROVIDER