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Tad Fennar, DPM
Foot & Ankle Surgery Podiatrist in San Pedro, California
NPI 1134151194

Tad Fennar is a Foot & Ankle Surgery Podiatrist based in San Pedro, CA and is specialized in Foot & Ankle Surgery. Tad Fennar practices in San Pedro, CA and has the professional credentials of DPM. The NPI Number for Tad Fennar is 1134151194 and holds a License No. E4107 (California).

The current practice location address for Tad Fennar is 1300 W 6Th St, San Pedro, CA and can be reached out via phone at 310-831-0728 and via fax at 310-831-8564.

Location: 1300 W 6Th St, San Pedro, CA, 90732-3531
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134151194
Provider Name
Tad Fennar
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1300 W 6Th St, San Pedro, CA, 90732-3531
Phone Number
310-831-0728
Fax Number
310-831-8564
Provider Enumeration Date
07/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000E41070 05 CA
institution
Provider Business Practice Location Address Details
Address
1300 W 6Th St
City
San Pedro
State
California
Zip
90732-3531
Phone Number
310-831-0728
Fax Number
310-831-8564
person
Provider Business Mailing Address Details
Address
1300 W 6Th St
City
San Pedro
State
California
Zip
90732-3531
Phone Number
310-831-0728
Fax Number
310-831-8564
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
E4107 (California)
Definition
Definition to come...
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