Organization
MICHAEL H. FENN, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL H. FENN M.D. (CHIEF)
(619) 466-0048
Entity
Organization
Contact information
Practice address
5565 GROSSMONT CENTER DR STE 352, LA MESA, CA 91942-3027
(619) 466-0048
Mailing address
5565 GROSSMONT CENTER DR STE 352, LA MESA, CA 91942-3027
(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
01/03/2007
Last updated
08/22/2020
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