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Provider Information for 1386612190

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DR. JEFFERSON CHARLES BIRCHALL M.D.

Gender: MALE

Individual NPI: 1386612190

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1386612190
Enumeration Date 2006-03-08
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 488 E VALLEY PKWY 411
ESCONDIDO, CA 92025-3363
United States

Phone: 760-745-2000 | Fax: 760-745-0451
View Map External Link
Primary Practice Address 488 E VALLEY PKWY 310
ESCONDIDO, CA 92025-3363
United States

Phone: 760-745-2000 | Fax: 760-745-0451
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other STATE LICENSE CA G071876
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine CA G071876