Individual
FRED FORTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23362 PERALTA DR STE 2, LAGUNA HILLS, CA 92653-1711
(949) 433-5115
(949) 713-6616
Mailing address
27702 CROWN VALLEY PARKWAY, SUITE D-4 #230, LADERA RANCH, CA 92694
(949) 433-5115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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