Fazio, Michael Joseph

Fazio, Michael Joseph is an individual health care provider with primary practice located at 2805 J Street Suite 100, Sacramento CA 95816. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Fazio, Michael Joseph can be contacted via phone (916) 492-1828.

Contact Information

Primary practice address
2805 J Street Suite 100 Sacramento CA 95816
Phone: (916) 492-1828
Fax: (916) 492-1834
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G059079 California
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X G059079 California

Profile Details

NPI number 1730185695
LBN Legal business name Fazio, Michael Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Mar 7th, 2023 - about 2 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 1730185695 NPPES
California Other 05D0615441 CLIA

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