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General NPI Number Information
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NPI Number | 1871892331
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Entity Type | Individual
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Provider Name | MARC JEFFREY HEIKENS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 15373 INNOVATION DR STE 360
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City | SAN DIEGO
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State | CA
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Zip | 92128-3426
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Country | US
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Telephone | 619-949-3479
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Fax | 619-625-3958
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Provider Business Mailing Address
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Address Line | 15373 INNOVATION DR STE 360
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City | SAN DIEGO
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State | CA
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Zip | 92128-3426
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Country | US
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Telephone | 619-949-3479
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Fax | 619-625-3958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A138136
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A138136
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License Number State | CA
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