Organization
CAN EMERGENCY PHYSICIANS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP J. FAGAN JR. M.D. (PRESIDENT)
(626) 447-0296
Entity
Organization
Contact information
Practice address
14662 NEWPORT AVE, TUSTIN, CA 92780-6064
(714) 619-7700
(626) 623-1227
Mailing address
PO BOX 845307, LOS ANGELES, CA 90084-5307
(626) 447-0296
(626) 623-1227
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
CA
Other
Enumeration date
11/13/2015
Last updated
08/21/2024
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