| Neil D. Fagen,m.d.,inc. | |
|
18411 Clark St 204 Tarzana CA 91356-3535 | |
| (818) 996-4796 | |
| (818) 996-4793 |
| Full Name | Neil D. Fagen,m.d.,inc. |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 18411 Clark St, Tarzana, California |
| Authorized Official Name and Position | Neil D Fagen (PRESIDENT) |
| Authorized Official Contact | 8189964796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neil D. Fagen,m.d.,inc. 18411 Clark St 204 Tarzana CA 91356-3535 Ph: (818) 996-4796 | Neil D. Fagen,m.d.,inc. 18411 Clark St 204 Tarzana CA 91356-3535 Ph: (818) 996-4796 |
| NPI Number | 1023311008 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023311008 | NPI | - | NPPES |
| 00G293040 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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