Individual
FABIOLA MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2374 E PACIFICA PL, COMPTON, CA 90220
(310) 225-3221
(310) 698-7040
Mailing address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3221
(310) 698-7040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
C54977
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
47986
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318039500
—
MN
01
—
P00415217
MEDICARE RAILROAD
MN
Enumeration date
02/09/2006
Last updated
07/13/2018
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