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Individual
JEREMY K. DEISCH
Active
Individual
JEREMY K. DEISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
A117116
CA
207ZP0101X
Anatomic Pathology Physician
Primary
A117116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A117116
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
06/09/2007
Last updated
07/06/2011
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