Provider Demographics
NPI:1457587073
Name:FURUBAYASHI, JILL KEI (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:KEI
Last Name:FURUBAYASHI
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 1:13280 EVENING CREEK DR S
Mailing Address - Street 2:STE 110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4101
Mailing Address - Country:US
Mailing Address - Phone:858-546-3800
Mailing Address - Fax:
Practice Address - Street 1:13280 EVENING CREEK DR S
Practice Address - Street 2:STE 110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4101
Practice Address - Country:US
Practice Address - Phone:858-546-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-139992085R0202X
HIMDR-57142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology