1518992668 NPI number — DR. PETER FREDERICK JOST M.D.

Table of content: LEXI CHRISTINE GOODIN (NPI 1316521156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518992668 NPI number — DR. PETER FREDERICK JOST M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOST
Provider First Name:
PETER
Provider Middle Name:
FREDERICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518992668
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
435 H ST
Provider Second Line Business Mailing Address:
SCRIPPS CHULA VISTA EMERGENCY DEPT.
Provider Business Mailing Address City Name:
CHULA VISTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91910-4307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-691-7290
Provider Business Mailing Address Fax Number:
619-691-7435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
435 H ST
Provider Second Line Business Practice Location Address:
SCRIPPS CHULA VISTA EMERGENCY DEPT.
Provider Business Practice Location Address City Name:
CHULA VISTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91910-4307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-691-7290
Provider Business Practice Location Address Fax Number:
619-691-7435
Provider Enumeration Date:
07/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  A81661 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207P00000X , with the licence number: 46917 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A816610 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53535359 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".