Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A052263 | CA |
NPI | 1326006941 |
---|---|
Provider Name | John Jahan |
First Address | La Mesa, CA 91943-2811 |
Second Address | San Diego, CA 92123-2762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 11/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A522630 | (05) | CA |
G72627 | (02) | CA |