Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | C37310 | CA |
NPI | 1114259827 |
---|---|
Provider Name | Dr. Charles Jaffe |
First Address | Del Mar, CA 92014-2430 |
Second Address | Del Mar, CA 92014-2430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2010 |
Last Update Date | 04/02/2010 |