Fatima, Fazilath
Fatima, Fazilath is an individual health care provider with primary practice located at 17360 Brookhurst St , Fountain Valley CA 92708-3720. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Fatima, Fazilath can be contacted via phone (657) 241-3592.Contact Information
Primary practice address
17360 Brookhurst St
Fountain Valley CA 92708-3720
Phone: (657) 241-3592
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301079615 | Michigan |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 4301079615 | Michigan |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 35.097068 | Ohio |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | C133691 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C133691 | California |
Profile Details
| NPI number | 1962429571 |
|---|---|
| LBN Legal business name | Fatima, Fazilath |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Aug 9th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962429571 | NPPES |
| Michigan | MEDICAID | 5178262-10 | |
| Michigan | Other | 1962429571 | |
| Michigan | Other | 70-0-F32947-0 |
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