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Organization

INSCRIPTIONS CHILDREN'S CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIAM W FAHIM D.O (PEDIATRICS)
(951) 813-3760
Entity
Organization

Contact information

Practice address
36243 INLAND VALLEY DR, SUITE #80, WILDOMAR, CA 92595-9549
(951) 813-3760
(951) 813-3761
Mailing address
36243 INLAND VALLEY DR, SUITE #80, WILDOMAR, CA 92595-9549
(951) 813-3760
(951) 813-3761

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20A9032
CA
261Q00000X
Clinic/Center
1669
CA
363LP0200X
Pediatric Nurse Practitioner
16134
CA

Other

Enumeration date
11/29/2010
Last updated
08/18/2014
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