# FAIRBANKS MEDICAL GROUP

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

## Provider details

- **NPI number:** 1780227918
- **Authorized official:** CARTER H SIGMON MD (PRESIDENT)
- **Authorized official phone:** (858) 255-1969

## Contact information

- **Practice address:** 16089 SAN DIEGUITO RD, H102, RANCHO SANTA FE, CA 92067
- **Practice address phone:** (858) 255-1969
- **Mailing address:** PO BOX 9227, RANCHO SANTA FE, CA 92067-4227
- **Mailing address phone:** (858) 255-1969
- **Mailing address fax:** (858) 759-6729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 10/21/2019
- **Last updated:** 10/21/2019