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Organization
MICHAEL M. FANOUS, D.P.M., INC.
Active
Organization
MICHAEL M. FANOUS, D.P.M., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL M. FANOUS D.P.M. (PRESIDENT)
(760) 951-1238
Entity
Organization
Contact information
Practice address
15366 11TH ST, SUITE D, VICTORVILLE, CA 92395-3726
(760) 951-1238
Mailing address
2834 HAMNER AVE, # 113, NORCO, CA 92860-1929
(760) 951-1238
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3544
CA
Other
Enumeration date
10/20/2006
Last updated
07/31/2008
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