Individual
DR. MICHAEL DAVID FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 ESCALON DR, MILL VALLEY, CA 94941-1339
(415) 515-7773
(415) 388-2829
Mailing address
15 ESCALON DR, MILL VALLEY, CA 94941-1339
(415) 515-7773
(415) 388-2829
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
G31552
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G315520
BLUE SHIELD
CA
05
—
00G315520
—
CA
Enumeration date
10/18/2005
Last updated
09/21/2015
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