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:
Health care specialties
Specialty | Code | License # | 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 last year |
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 | 1730185695 | NPPES |
California | Other | 05D0615441 | CLIA |
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