Individual
DR. MARIO ENRIQUE FAJARDO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
COMMANDANT US COAST GUARD CG-1122, 2100 SECOND ST. SW, WASHINGTON, DC 20593-0001
(202) 267-0801
Mailing address
1951 HOLLY CREEK PL, CONCORD, CA 94521-1550
(925) 825-5905
(925) 825-5906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
143895-1
NY
Other
Enumeration date
12/14/2005
Last updated
07/08/2007
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