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Organization

DR. JOHN E. FAGAN, OPTOMETRIST, INC.

Active
Other names
Dr. John E. Fagan
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN EDWARD FAGAN JR. O.D. (PRESIDENT)
(661) 822-1212
Entity
Organization

Contact information

Practice address
20231 W VALLEY BLVD, SUITE G, TEHACHAPI, CA 93561-6865
(661) 822-1212
(661) 822-3296
Mailing address
20231 W VALLEY BLVD, SUITE G, TEHACHAPI, CA 93561-6865
(661) 822-1212
(661) 822-3296

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7946T
CA
261QC1800X
Corporate Health Clinic/Center
7946T
CA

Other

Enumeration date
10/17/2008
Last updated
03/25/2009
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