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Individual
DR. PHILIP J. FAGAN JR.
Active
Individual
DR. PHILIP J. FAGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C32505
CA
207R00000X
Internal Medicine Physician
C32505
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C325050
BLUE SHIELD
CA
05
—
00C325050
—
CA
01
—
930085818
RAILROAD MEDICARE
CA
01
—
C32505
BLUE CROSS
CA
Enumeration date
06/08/2005
Last updated
01/23/2024
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