Healthcare Provider Details

I. General information

NPI: 1952225237
Provider Name (Legal Business Name): JESSE TUKUAFU DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3989 32ND ST
SAN DIEGO CA
92104-2001
US

IV. Provider business mailing address

8450 VIA SONOMA UNIT 104
LA JOLLA CA
92037-2729
US

V. Phone/Fax

Practice location:
  • Phone: 619-283-2097
  • Fax:
Mailing address:
  • Phone: 801-836-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSE TIPASA TUKUAFU
Title or Position: OWNER
Credential: DPM
Phone: 801-836-2696