Provider Demographics
NPI:1366018350
Name:YVETTE CANABA DPM APC
Entity Type:Organization
Organization Name:YVETTE CANABA DPM APC
Other - Org Name:FORTITUDE FOOT & ANKLE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANABA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:619-449-9100
Mailing Address - Street 1:2245 2ND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2063
Mailing Address - Country:US
Mailing Address - Phone:619-449-9100
Mailing Address - Fax:619-449-0722
Practice Address - Street 1:8772 CUYAMACA ST STE 102
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4207
Practice Address - Country:US
Practice Address - Phone:619-449-9100
Practice Address - Fax:619-449-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty