Deisch, Jeremy K.
Deisch, Jeremy K. is an individual health care provider with primary practice located at 11234 Anderson St Room 2151, Loma Linda CA 92354-2804. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Neuropathology. Allopathic & Osteopathic Physicians / Anatomic Pathology is his primary health care specialty. Deisch, Jeremy K. can be contacted via phone (909) 558-5170.Contact Information
Primary practice address
11234 Anderson St Room 2151
Loma Linda CA 92354-2804
Phone: (909) 558-5170
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | A117116 | California |
| Allopathic & Osteopathic Physicians / Neuropathology | 207ZN0500X | A117116 | California |
Profile Details
| NPI number | 1619170222 |
|---|---|
| LBN Legal business name | Deisch, Jeremy K. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2007 |
| Last updated | Jul 6th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619170222 | NPPES |
| California | Other | A117116 | CALIFORNIA MEDICAL LICENSE |
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