Provider Demographics
NPI:1366408569
Name:PARTHEMORE, JACQUELINE G (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:G
Last Name:PARTHEMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JACQUELINE
Other - Middle Name:P
Other - Last Name:BLANK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2434
Mailing Address - Street 2:6416 EL SICOMORO
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-2434
Mailing Address - Country:US
Mailing Address - Phone:858-756-2917
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-7419
Practice Address - Fax:858-552-7420
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG016942207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism