# ROBERT M. FAY, M.D., MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275550154
- **Authorized official:** DR. ROBERT MICHAEL FAY M.D. (PRESIDENT)
- **Authorized official phone:** (760) 485-7402

## Contact information

- **Practice address:** 3625 MARTIN LUTHER KING JR BLVD STE 9, LYNWOOD, CA 90262-3509
- **Practice address phone:** (760) 485-7402
- **Practice address fax:** (760) 775-2656
- **Mailing address:** 79090 AVENUE 42 APT F101, BERMUDA DUNES, CA 92203-7909
- **Mailing address phone:** (761) 485-7402
- **Mailing address fax:** (760) 775-2656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | A68720 | CA | — |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | A68720 | CA | — |
| 207T00000X | Neurological Surgery Physician | A68720 | CA | — |
| 207X00000X | Orthopaedic Surgery Physician | A68720 | CA | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | A68720 | CA | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | A68720 | CA | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | A68720 | CA | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | A68720 | CA | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | A68720 | CA | — |
| 207XX0801X | Orthopaedic Trauma Physician | A68720 | CA | — |
| 208200000X | Plastic Surgery Physician | A68720 | CA | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | A68720 | CA | — |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | A68720 | CA | — |
| 2086S0102X | Surgical Critical Care Physician | A68720 | CA | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | A68720 | CA | — |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 06/17/2013