Michael H. Fenn, M.D., Inc.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G17188 Issued in CA

Legal business name

MICHAEL H. FENN, M.D., INC.

Practice address

5565 Grossmont Center Dr Ste 352
La Mesa, CA 91942-3027

Phone

(619) 466-0048

NPI assigned

Jan 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael H. Fenn, M.D.NPI 1013946904

Title

Chief

Phone

(619) 466-0048

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael H. Fenn, M.D.

  • Otolaryngology Physician
  • La Mesa, CA
  • NPI 1013946904
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467519629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR STE 352",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423027",
            "telephone_number": "619-466-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR STE 352",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423027",
            "telephone_number": "619-466-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL H. FENN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FENN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "619-466-0048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G17188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G171880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nechelle Fabiana Metayer, NP-C
• Gary Lee Meyer
• Joanne Meyer, PA-C
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• Michael E Musicant MD
• Michael H. Michalski, M.D., a Medical Corporation
• Michael Lajin, M.D., Inc
• Michael P. Koumjian, MD, a Professional Corporation
• Michael R. Mantell, PH. D., Inc
• Michelle Stewart Nursing, Inc.

• Otolaryngology Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.