Provider Demographics
NPI:1538744792
Name:JAFFAR, RUAA HESHAM
Entity type:Individual
Prefix:
First Name:RUAA
Middle Name:HESHAM
Last Name:JAFFAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3913
Mailing Address - Country:US
Mailing Address - Phone:619-642-4000
Mailing Address - Fax:
Practice Address - Street 1:311 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3913
Practice Address - Country:US
Practice Address - Phone:619-642-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)