# JAY MUKKER DPM INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962722983
- **Authorized official:** DR. JAY MUKKER DPM (OWNER)
- **Authorized official phone:** (559) 224-5101

## Contact information

- **Practice address:** 7210 N MILBURN AVE, SUITE 101, FRESNO, CA 93722-0022
- **Practice address phone:** (559) 224-5101
- **Practice address fax:** (559) 224-4396
- **Mailing address:** 7210 N MILBURN AVE, SUITE 101, FRESNO, CA 93722-0022
- **Mailing address phone:** (559) 224-5101
- **Mailing address fax:** (559) 224-4396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E4656 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | E46560 | CA | — |
| 332BC3200X | Customized Equipment (DME) | E46560 | CA | — |
| 335E00000X | Prosthetic/Orthotic Supplier | E46560 | CA | — |

## Other

- **Enumeration date:** 06/02/2010
- **Last updated:** 06/06/2012