Basic Information
| Provider Information | |||||||||
| NPI: | 1730317256 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NOERENBERG | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | SUSAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16955 VIA DEL CAMPO | ||||||||
| Address2: | STE 215 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921277720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586736100 | ||||||||
| FaxNumber: | 8586736110 | ||||||||
| Practice Location | |||||||||
| Address1: | 2185 W CITRACADO PKWY | ||||||||
| Address2: | |||||||||
| City: | ESCONDIDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920294159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4222815000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2009 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2013022035 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | A116348 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.