Individual
JERRY M FABRIKANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5565 GROSSMONT CENTER DR, BLDG 3 # 353, LA MESA, CA 91942-3007
(619) 465-3443
(619) 466-7311
Mailing address
5565 GROSSMONT CENTER DR, BLDG 3 #353, LA MESA, CA 91942-3007
(619) 465-3443
(619) 466-7311
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
000E23120
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000E23120
CA
Other
Enumeration date
05/05/2006
Last updated
03/17/2009
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