MEDICARE: DR. JAGPREET MUKKER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	E4656	CA

General Provider Information

NPI Number	:	1699732156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAGPREET MUKKER DPM

Provider Business Mailing Address
First Line	:	7210 N MILBURN AVE STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 N MILBURN AVE STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8449
Country	:	US
Telephone Number	:	559-224-5101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/08/2021

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