Individual
FADY REZK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13422 NEWPORT AVE STE L, TUSTIN, CA 92780-3746
(714) 544-1521
Mailing address
PO BOX 740, LAKEWOOD, CA 90714-0740
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2024
Last updated
11/24/2024
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