Individual
DR. MICHAEL H. FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5565 GROSSMONT CENTER DR, SUITE# 352, LA MESA, CA 91942-3020
(619) 466-0048
Mailing address
5565 GROSSMONT CENTER DR, SUITE# 352, LA MESA, CA 91942-3020
(619) 466-0048
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G17188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G171880
—
CA
Enumeration date
07/02/2006
Last updated
07/08/2007
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