Fagan, Marie Louise
Fagan, Marie Louise is an sole proprietor health care provider with primary practice located at 4077 32Nd St Apt 8, San Diego CA 92104-2080. She recently has only one registered license in Other Service Providers / Military Health Care Provider, which is considered as her primary health care specialty. Fagan, Marie Louise can be contacted via phone (678) 764-4067.Contact Information
Primary practice address
4077 32Nd St Apt 8
San Diego CA 92104-2080
Phone: (678) 764-4067
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X |
Profile Details
| NPI number | 1104261726 |
|---|---|
| LBN Legal business name | Fagan, Marie Louise |
| Credentials | IDC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 9th, 2013 |
| Last updated | May 9th, 2013 - about 12 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 | 1104261726 | NPPES |
| Other | 1710-1002X | IDC |
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