JERRY M FABRIKANT DPM INC NPI 1851578819

NPI Information

  • NPI: 1851578819
  • Provider Name: JERRY M FABRIKANT DPM, INC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 5565 GROSSMONT CENTER DR STE 3
    STE 353
    LA MESA, CA
    ZIP 91942
  • Phone: (619) 465-3443

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NPI Details

JERRY M FABRIKANT DPM, INC is a foot and ankle surgery podiatrist in La Mesa, CA. JERRY M FABRIKANT DPM, INC NPI is 1851578819. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5565 GROSSMONT CENTER DR STE 3
STE 353
LA MESA, CA
ZIP 91942-007
Phone: (619) 465-3443
Fax: (619) 466-7311

The provider's authorized official is Jerry M Fabrikant .
The authorized official title is President and has the following contact phone number (619) 465-3443.

The enumeration date for this NPI number is 1/22/2008 and was last updated on 6/19/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213EP1101XPodiatristPrimary Podiatric MedicineNo
2213ES0103XPodiatristFoot & Ankle SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16124170001MEDICARE NSCCALIFORNIA
20367040001MEDICARE NSCCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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