Individual
WARREN C FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
637 NORTH 13TH AVENUE, UPLAND, CA 91786
(909) 946-4106
(909) 949-4366
Mailing address
637 N 13TH AVE, UPLAND, CA 91786-4906
(909) 946-4106
(909) 949-4366
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
A32805
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A328050
—
CA
Enumeration date
07/03/2006
Last updated
07/08/2007
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