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Individual

JENNIFER JOY PENDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2655 CAMINO DEL RIO N STE 425, SAN DIEGO, CA 92108-1633
(619) 286-6687
(619) 286-6695
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A80748
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A8074800
CA
01
GW221Z
MEDICARE PTAN
CA
Enumeration date
04/22/2006
Last updated
10/17/2023
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