Individual
GREGORY M. FENATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(858) 344-7049
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A12530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A12530
MEDICAL LICENSE
CA
Enumeration date
01/20/2012
Last updated
06/09/2015
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