Organization
C. H. FAGAN, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER HEIN FAGAN M.D. (PRESIDENT)
(909) 866-5868
Entity
Organization
Contact information
Practice address
41933 BIG BEAR BLVD., BIG BEAR LAKE, CA 92315-6848
(909) 866-5868
(909) 866-5860
Mailing address
P. O. BOX 6848 PMB 278, BIG BEAR LAKE, CA 92315-6848
(909) 866-5868
(909) 866-5860
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
G42774
CA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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