Provider Demographics
NPI:1821539180
Name:ISRAEL, JENNIFER R (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:R
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 MULVANEY AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-4469
Mailing Address - Country:US
Mailing Address - Phone:916-734-3565
Mailing Address - Fax:
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
Is Sole Proprietor?:No
Enumeration Date:2017-03-19
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A17135207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine