Organization
JAY MUKKER DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY MUKKER DPM (OWNER)
(559) 224-5101
Entity
Organization
Contact information
Practice address
7210 N MILBURN AVE, SUITE 101, FRESNO, CA 93722-0022
(559) 224-5101
(559) 224-4396
Mailing address
7210 N MILBURN AVE, SUITE 101, FRESNO, CA 93722-0022
(559) 224-5101
(559) 224-4396
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4656
CA
332B00000X
Durable Medical Equipment & Medical Supplies
E46560
CA
332BC3200X
Customized Equipment (DME)
E46560
CA
335E00000X
Prosthetic/Orthotic Supplier
E46560
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E46560
—
CA
Enumeration date
06/02/2010
Last updated
06/06/2012
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