Healthcare Provider Details
I. General information
NPI: 1750321378
Provider Name (Legal Business Name): JOHN MICHAEL PABERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/08/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2304 JUAN ST
SAN DIEGO CA
92103-1111
US
IV. Provider business mailing address
2304 JUAN ST
SAN DIEGO CA
92103-1111
US
V. Phone/Fax
- Phone: 858-539-5268
- Fax:
- Phone: 858-539-5268
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NR1301X |
| Taxonomy | Rural Acute Care Hospital |
| License Number | G74686 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD60225583 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: