Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | G55011 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G55011 | CA |
N | 207RI0011X | Interventional Cardiology | G55011 | CA |
NPI | 1194706242 |
---|---|
Provider Name | Brian E Jaski |
First Address | San Diego, CA 92123-4233 |
Second Address | San Diego, CA 92123-4233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 17/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G550110 | (05) | CA |
A52847 | (02) | CA |