Organization
MICHAEL M. FANOUS, D.P.M., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL M. FANOUS D.P.M. (PRESIDENT)
(760) 951-1238
Entity
Organization
Contact information
Practice address
15366 11TH ST, SUITE D, VICTORVILLE, CA 92395-3726
(760) 951-1238
Mailing address
2834 HAMNER AVE, # 113, NORCO, CA 92860-1929
(760) 951-1238
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3544
CA
Other
Enumeration date
10/20/2006
Last updated
07/31/2008
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