Healthcare Provider Details

I. General information

NPI: 1770685323
Provider Name (Legal Business Name): JEFFREY A MERSKY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12865 POINTE DEL MAR WAY SUITE 170
DEL MAR CA
92014-3860
US

IV. Provider business mailing address

3912 CAMINITO DEL MAR CV
SAN DIEGO CA
92130-2518
US

V. Phone/Fax

Practice location:
  • Phone: 858-720-8380
  • Fax: 858-350-3704
Mailing address:
  • Phone: 858-720-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC17551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: