Organization Active NPI

Fereshteh Jahanpanah M.D., a Professional Medical Corporation

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1396082517
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G65104 Issued in CA
Legal business name
FERESHTEH JAHANPANAH M.D., A PROFESSIONAL MEDICAL CORPORATION
Practice address
343 E Main St Ste 101
El Cajon, CA 92020-3942
Phone
(619) 447-6001
Fax
(619) 447-6096
NPI assigned
Jan 8, 2013
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charlene Anne Wulff
Title
Office Manager
Phone
(619) 312-7049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G65104 CA Primary

Addresses

Primary practice location

343 E Main St Ste 101
El Cajon, CA 92020-3942

Mailing address

PO Box 1626
El Cajon, CA 92022-1626
Phone (619) 447-6001

Other identifiers 1

IdentifierTypeStateIssuer
1609194570MedicaidCA

Other names 1

  • Fereshteh Jahanpanah, M.D., APMC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130211000168 CA Part B Supplier - Clinic/Group Practice 4587818083 Receives reassigned benefits from 1 practitioner
Practice locations: El Cajon, CA

National Provider Directory

National Provider Directory

Locations

343 E Main St
Ste 101
El Cajon, CA 92020
Phone (619) 447-6001

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1396082517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1626",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920221626",
            "telephone_number": "619-447-6001",
            "fax_number": "619-447-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E MAIN ST STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203942",
            "telephone_number": "619-447-6001",
            "fax_number": "619-447-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERESHTEH JAHANPANAH M.D., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "WULFF",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-312-7049"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G65104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609194570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fereshteh Jahanpanah, M.D., APMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.