Provider Demographics
NPI:1003651621
Name:DR. JENNIFER ISRAEL DO, INC
Entity type:Organization
Organization Name:DR. JENNIFER ISRAEL DO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-819-7224
Mailing Address - Street 1:501 WASHINGTON ST STE 725
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2241
Mailing Address - Country:US
Mailing Address - Phone:619-299-2570
Mailing Address - Fax:619-299-2216
Practice Address - Street 1:501 WASHINGTON ST STE 725
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2241
Practice Address - Country:US
Practice Address - Phone:619-299-2570
Practice Address - Fax:619-299-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty