Fazio, Doreen T

Fazio, Doreen T is an individual health care provider with primary practice located at 14914 Sherman Way , Van Nuys CA 91405-2113. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Fazio, Doreen T can be contacted via phone (818) 787-2020.

Contact Information

Primary practice address
14914 Sherman Way Van Nuys CA 91405-2113
Phone: (818) 787-2020
Fax: (818) 787-8652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G041260 California

Profile Details

NPI number 1831194398
LBN Legal business name Fazio, Doreen T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Dec 30th, 2008 - about 18 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 1831194398 NPPES
California MEDICAID GR0063310
California Other W13323
California Other WG41260E
California Other ZZZ91696Z

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