Healthcare Provider Details

I. General information

NPI: 1366018350
Provider Name (Legal Business Name): YVETTE CANABA DPM APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8772 CUYAMACA ST STE 102
SANTEE CA
92071-4207
US

IV. Provider business mailing address

2245 2ND AVE APT 2
SAN DIEGO CA
92101-2063
US

V. Phone/Fax

Practice location:
  • Phone: 619-449-9100
  • Fax: 619-449-0722
Mailing address:
  • Phone: 619-449-9100
  • Fax: 619-449-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. YVETTE CANABA
Title or Position: CEO
Credential: DPM
Phone: 619-449-9100