Fagan, Thomas

Fagan, Thomas is an individual health care provider with primary practice located at 9300 Valley Childrens Pl # Sc05 , Madera CA 93636-8761. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Fagan, Thomas can be contacted via phone (559) 353-5700.

Contact Information

Primary practice address
9300 Valley Childrens Pl # Sc05 Madera CA 93636-8761
Phone: (559) 353-5700
Fax: (559) 353-5708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 44826 Colorado
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 53605 Tennessee
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X G174751 California

Profile Details

NPI number 1134116494
LBN Legal business name Fagan, Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Dec 15th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134116494 NPPES
Colorado MEDICAID 30488001

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