Provider Demographics
NPI:1750321378
Name:PABERS, JOHN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:PABERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 JUAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1111
Mailing Address - Country:US
Mailing Address - Phone:858-539-5268
Mailing Address - Fax:
Practice Address - Street 1:2304 JUAN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1111
Practice Address - Country:US
Practice Address - Phone:858-539-5268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74686282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00255264OtherRAILROAD MEDICARE
VA010176212Medicaid
CA1750321378,Medicaid
VA010176212Medicaid
CACM300ZMedicare PIN
VAP00255264OtherRAILROAD MEDICARE