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Organization

KESANAPALLI PEDIATRICS PROFESSIONAL MEDICAL CORPORATION

Active
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Organization

KESANAPALLI PEDIATRICS PROFESSIONAL MEDICAL CORPORATION

Active
Other names
Bright Pediatrics, Jacobson Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
DEEPTHI KESANAPALLI M.D. (CEO)
(858) 576-8010
Entity
Organization

Contact information

Practice address
7910 FROST STREET, SUITE 335, SAN DIEGO, CA 92123-2771
(858) 576-8010
(858) 576-7391
Mailing address
7910 FROST STREET, SUITE 335, SAN DIEGO, CA 92123-2771
(858) 576-8010
(858) 576-7391

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A56064
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A560640
—
CA
01
—
ZZZ01416Z
BLUE SHIELD
CA
Enumeration date
05/16/2008
Last updated
09/13/2024
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