Individual
MR. DOUGLAS LEE FAISON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
35000 GUADALCANAL AVE, BRANCH MEDICAL CLINIC, MCRD BLD 596, SAN DIEGO, CA 92140-5599
(619) 524-0789
Mailing address
23759 MOONGLOW CT, RAMONA, CA 92065-4517
(619) 524-0789
(760) 788-2546
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1032153
GA
Other
Enumeration date
02/02/2006
Last updated
07/08/2007
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