Individual
DR. ELIAS JASON FANOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2130 CITRACADO PKWY STE 220, ESCONDIDO, CA 92029-4151
(760) 743-0546
(760) 317-9769
Mailing address
2130 CITRACADO PKWY STE 220, ESCONDIDO, CA 92029-4151
(951) 902-9475
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A179829
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A179829
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2019
Last updated
07/02/2025
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