Individual
CHRIS MICHAEL FADEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 STOCKDALE HWY STE 103, BAKERSFIELD, CA 93311-3621
(661) 324-6593
(602) 512-6516
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A065257
CA
Other
Enumeration date
11/06/2006
Last updated
04/07/2023
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