Individual provider · Type 1 NPI

Melissa Joyann Fortner, PAC

Medical Physician Assistant · San Diego, CA

NPI number 1972584209 Active

Practice location

4290 Polk Ave
San Diego, CA 92105-1524

Fax (619) 563-0015

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA15119 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1972584209

Melissa Joyann Fortner, PAC's National Provider Identifier is 1972584209, issued on Nov 14, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Diego, CA. The record was last updated on Jul 13, 2026.