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Individual
DR. MARK TERRENCE FAY
Active
Individual
DR. MARK TERRENCE FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
G58765
CA
207W00000X
Ophthalmology Physician
Primary
MD16253
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004571003
BCBS
OR
05
—
042937
—
OR
01
—
180011820
RAILROAD MEDICARE
OR
01
—
A002
TRICARE
OR
01
—
F2640501647611
VISION SERVICE PLAN
OR
01
—
XPY094350
MEDI-CAL
CA
Enumeration date
03/24/2006
Last updated
02/11/2021
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