Big Bear Family Practice Professional Corporation
NPI #1225543473 in Big Bear Lake, California
Provider Information
- NPI Number
- 1225543473
- Entity Type
- Organization
- Organization Name
- Big Bear Family Practice Professional Corporation
- Primary Specialty
- Family Medicine
- Enumeration Date
- Dec 11, 2017
- Last Updated
- Jan 2, 2018
Practice Location
- Address
- 41945 BIG BEAR BLVD
- Address 2
- SUITE 200
- City
- Big Bear Lake
- State
- California
- ZIP Code
- 92315
- Phone
- (909) 866-6567
Authorized Official
- Name
- CHRISTOPHER H. FAGAN, M.D.
- Title
- OWNER
- Phone
- (909) 866-6567
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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