DR. JORDAN FABRIKANT (NPI# 1649585753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649585753 |
| Entity Type | Individual |
| Full Name | DR. JORDAN FABRIKANT |
| Credential | D.O. |
| Practice Address |
4060 Fourth Ave Ste 415 West Dermatology & Surgery Medical Group San Diego CA 92103-2121 |
| Mailing Address |
2285 Corporate Cir 200 Henderson NV 89074-7759 |
| Practice Telephone | 6192989809 |
| Practice Fax Number | 6192989823 |
| Mailing Telephone | 7023602100 |
| Mailing Fax Number | 9497832880 |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2015-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
13142 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4060 FOURTH AVE STE 415 WEST DERMATOLOGY & SURGERY MEDICAL GROUP |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336296912 | Lisa Ann Zaleski | Dermatology | 4060 Fourth Ave Ste 415, San Diego, CA 92103-2121 | 2007-01-04 |
| 1497390645 | Kara Elizabeth Kane | Physician Assistant | 4060 Fourth Ave Ste 415, San Diego, CA 92103-2121 | 2019-11-12 |
| 1053666370 | Kelly L Reed | Dermatology | 4060 Fourth Ave Ste 415, San Diego, CA 92103-2121 | 2012-07-24 |
| 1013277045 | Stephen Erik Hemperly | Dermatology | 4060 Fourth Ave Ste 415, San Diego, CA 92103 | 2012-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982803821 | Bayside Dermatology Incorporated | Dermatology | 8174 Regents Rd Apt 303, San Diego, CA 92122-1371 | 2007-07-12 |
| 1316136740 | Dermatology Professionals Incorporated | Dermatology | 10672 Wexford Street, Suite 205, San Diego, CA 92131-3974 | 2007-10-22 |
| 1427176221 | Regents of The University of California- Ucsd Medical Group | Dermatology | 200 West Arbor Dr, Mc8201-ucsd Medical Group, Provider Enrollment Dept., San Diego, CA 92103-1911 | 2007-03-27 |
| 1316913650 | Jeffrey S. Eaton | Dermatology | 12395 El Camino Real, Suite 200, San Diego, CA 92130-3082 | 2006-02-27 |
| 1457323263 | Bruce Feldman | Dermatology | 34800 Bob Wilson Dr, Nmcsd, Attn: Medical Staff Services, San Diego, CA 92134-1098 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578173936 | Mill Valley Dermatology, Inc | Dermatology | 655 Redwood Hwy Frontage Rd Ste 100, Mill Valley, CA 94941-3031 | 2020-07-31 |
| 1710508874 | Zhe Hou, M.d., Ph.d., A Professional Corporation | Dermatology | 3000 E Imperial Hwy Ste 150, Brea, CA 92821-6782 | 2020-04-29 |
| 1073152112 | Agape Dermatology PC | Dermatology | 18800 Main St Ste 111, Huntington Beach, CA 92648-1717 | 2020-01-06 |
| 1497392492 | Pacifica Dermatology | Dermatology | 2460 N Ponderosa Dr Ste A117, Camarillo, CA 93010-2468 | 2019-12-09 |
| 1518447689 | Razieh Soltani Arabshahi Md Inc | Dermatology | 960 E Green St Ste 330, Pasadena, CA 91106-2401 | 2018-08-18 |
| 1811497928 | Laca Dermatology, Inc | Dermatology | 4955 Van Nuys Blvd Ste 516, Sherman Oaks, CA 91403-1832 | 2018-02-15 |
| 1427509959 | Northern California Medical Assoc Inc | Dermatology | 555 S Dora St Ste B, Ukiah, CA 95482-5424 | 2016-10-19 |
| 1376091553 | Integrated Dermatology of Mission Viejo, Apmc | Dermatology | 26691 Plaza Ste 230, Mission Viejo, CA 92691-6300 | 2016-09-15 |
| 1164835518 | Laila Elkeeb, M.d., Inc | Dermatology | 242 Wicker, Irvine, CA 92618-1170 | 2014-06-03 |
| 1518303924 | Christine Shaver | Dermatology | 1301 20th St Ste 570, Santa Monica, CA 90404-2118 | 2013-05-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.