Fortin, Mary Douglas

Fortin, Mary Douglas is an individual health care provider with primary practice located at 710 Lawerence Expressway, Dept.174 , Santa Clara CA 95051. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Fortin, Mary Douglas can be contacted via phone (408) 851-1495.

Contact Information

Primary practice address
710 Lawerence Expressway, Dept.174 Santa Clara CA 95051
Phone: (408) 851-1495
Fax: (408) 851-1499
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X PT10606 California

Profile Details

NPI number 1215091947
LBN Legal business name Fortin, Mary Douglas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2006
Last updated Jul 8th, 2007 - 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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