Organization
JOHN A FAGAN MD FAMILY PRACTICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ANDREW FAGAN M.D. (OWNER)
(909) 982-7741
Entity
Organization
Contact information
Practice address
10787 LAUREL ST, RANCHO CUCAMONGA, CA 91730-3828
(909) 982-7741
(909) 931-9568
Mailing address
10787 LAUREL ST, RANCHO CUCAMONGA, CA 91730-3828
(909) 982-7741
(909) 931-9568
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G060968
CA
Other
Enumeration date
12/08/2007
Last updated
02/04/2013
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