Individual
JEJO D. KOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 471-9186
(619) 543-8255
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101250440
VA
207R00000X
Internal Medicine Physician
50317
TN
207R00000X
Internal Medicine Physician
60264643
WA
207R00000X
Internal Medicine Physician
A122014
CA
207R00000X
Internal Medicine Physician
MD2011-0624
NM
207R00000X
Internal Medicine Physician
P5199
TX
207R00000X
Internal Medicine Physician
TL34447
SC
208M00000X
Hospitalist Physician
Primary
A122014
CA
Other
Enumeration date
06/26/2008
Last updated
09/21/2017
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