Organization Active NPI

Fereshteh Jahanpanah a Professional Medical Corporation

  • Internal Medicine Physician
  • El Cajon, CA
National Provider Identifier
1609194570
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G65104 Issued in CA
Legal business name
FERESHTEH JAHANPANAH A PROFESSIONAL MEDICAL CORPORATION
Practice address
1333 E Main St
El Cajon, CA 92021-6540
Phone
(619) 447-6001
Fax
(619) 447-6096
NPI assigned
May 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Dr. Fereshteh Jahanpanah, M.D.
Title
President/Owner
Phone
(619) 447-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G65104 CA Primary

Addresses

Primary practice location

1333 E Main St
El Cajon, CA 92021-6540

Mailing address

1333 E Main St
El Cajon, CA 92021-6540
Phone (619) 447-6001

Other identifiers 1

IdentifierTypeStateIssuer
1609194570MedicaidCA

National Provider Directory

National Provider Directory

Locations

1319 E Main St
El Cajon, CA 92021
Phone (619) 447-6001

1333 E Main St
El Cajon, CA 92021
Phone (619) 447-6001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1609194570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920216540",
            "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": "1333 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920216540",
            "telephone_number": "619-447-6001",
            "fax_number": "619-447-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERESHTEH JAHANPANAH A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-17",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "JAHANPANAH",
        "authorized_official_first_name": "FERESHTEH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "619-447-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G65104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609194570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.