Individual
HOLLY K FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-7909
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-7909
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
023260
NY
363AM0700X
Medical Physician Assistant
Primary
PA60834
CA
Other
Enumeration date
03/28/2019
Last updated
01/04/2023
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