Michael K Fairbanks Dpm a Professional Corporation
NPI #1629358411 in San Dimas, California
Provider Information
- NPI Number
- 1629358411
- Entity Type
- Organization
- Organization Name
- Michael K Fairbanks Dpm a Professional Corporation
- Primary Specialty
- Podiatrist
- Enumeration Date
- Aug 24, 2011
- Last Updated
- Nov 9, 2016
Practice Location
- Address
- 425 W BONITA AVE
- Address 2
- SUITE 110
- City
- San Dimas
- State
- California
- ZIP Code
- 91773-2541
- Phone
- (909) 599-0981
Authorized Official
- Name
- MICHAEL K FAIRBANKS, DPM
- Title
- SOLE OWNER
- Phone
- (619) 465-4972
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist |
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