Individual
FAN MO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1309 S MARY AVE, SUNNYVALE, CA 94087-3050
(408) 523-3460
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A17752
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
20A17752
CA
Other
Enumeration date
04/11/2018
Last updated
06/23/2025
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