Individual
DR. TIMOTHY JOSEPH FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8010 FROST ST, STE 414, SAN DIEGO, CA 92123-2778
(858) 966-7711
Mailing address
3860 CALLE FORTUNADA, STE #210, SAN DIEGO, CA 92123-4802
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A80244
CA
2086S0120X
Pediatric Surgery Physician
Primary
A80244
CA
Other
Enumeration date
07/17/2008
Last updated
12/08/2011
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