Basic Information
| Provider Information | |||||||||
| NPI: | 1568728210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOITOZA JOHNSON | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | MOITOZA | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9850 GENESSE AVE, SUITE 900 | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192607125 | ||||||||
| FaxNumber: | 6196863874 | ||||||||
| Practice Location | |||||||||
| Address1: | 9888 GENESSE AVE | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586267780 | ||||||||
| FaxNumber: | 6196863874 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2012 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A127356 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A127356 | CA | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.