Organization
MICHAEL J FAZIO, MD, SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE BUKOWIEC (MEDICAL BILLING REPRESENTATIVE)
(916) 492-1828
Entity
Organization
Contact information
Practice address
2805 J ST, STE 100, SACRAMENTO, CA 95816-4307
(916) 492-1828
(916) 492-1834
Mailing address
FILE # 74529, PO BOX 60000, SAN FRANCISCO, CA 94160
(916) 492-1828
(916) 492-1834
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
CLN 670
CA
Other
Enumeration date
06/09/2005
Last updated
08/22/2020
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