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Organization
BIG BEAR FAMILY PRACTICE PROFESSIONAL CORPORATION
Active
Organization
BIG BEAR FAMILY PRACTICE PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER H. FAGAN M.D. (OWNER)
(909) 866-6567
Entity
Organization
Contact information
Practice address
41945 BIG BEAR BLVD, SUITE 200, BIG BEAR LAKE, CA 92315
(909) 866-6567
Mailing address
PO BOX 1656, BIG BEAR LAKE, CA 92315-1656
(909) 866-6567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42774
CA
Other
Enumeration date
12/11/2017
Last updated
01/02/2018
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