Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | A11079 | CA |
NPI | 1346531027 |
---|---|
Provider Name | Dr. Karisa Ann Jahn |
First Address | Fontana, CA 92335-6720 |
Second Address | Fontana, CA 92335-6720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2011 |
Last Update Date | 03/12/2021 |