Provider Demographics
NPI:1992970321
Name:SOIFER, JENNIFER TAITZ (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TAITZ
Last Name:SOIFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910805
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92191-0805
Mailing Address - Country:US
Mailing Address - Phone:818-590-8807
Mailing Address - Fax:
Practice Address - Street 1:4647 ZION AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2507
Practice Address - Country:US
Practice Address - Phone:858-528-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-27
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99045207P00000X
NY253941207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine