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Jonathan Nissanoff, MD
Specialist in Poway, California
NPI 1134135155

Jonathan Nissanoff is a Specialist based in San Diego, CA. Jonathan Nissanoff practices in Poway, CA and has the professional credentials of MD. The NPI Number for Jonathan Nissanoff is 1134135155 and holds a License No. G82348 (California).

The current practice location address for Jonathan Nissanoff is 15525 Pomerado Rd Ste E6, Poway, CA and can be reached out via phone at 858-451-2280 and via fax at 858-451-2006.

Location: 15525 Pomerado Rd Ste E6, Poway, CA, 92150-2530
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134135155
Provider Name
Jonathan Nissanoff
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
15525 Pomerado Rd Ste E6, Poway, CA, 92150-2530
Phone Number
858-451-2280
Fax Number
858-451-2006
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G823480 05 CA
institution
Provider Business Practice Location Address Details
Address
15525 Pomerado Rd Ste E6
City
Poway
State
California
Zip
92064-2427
Phone Number
858-451-2280
Fax Number
858-451-2006
person
Provider Business Mailing Address Details
Address
15525 Pomerado Rd Ste E6
City
Poway
State
California
Zip
92064-2427
Phone Number
858-451-2280
Fax Number
858-451-2006
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G82348 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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