Organization
BIG BEAR FAMILY PRACTICE PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER H. FAGAN M.D. (OWNER)
(909) 866-6567
Entity
Organization
Contact information
Practice address
41945 BIG BEAR BLVD, SUITE 200, BIG BEAR LAKE, CA 92315
(909) 866-6567
Mailing address
PO BOX 1656, BIG BEAR LAKE, CA 92315-1656
(909) 866-6567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42774
CA
Other
Enumeration date
12/11/2017
Last updated
01/02/2018
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