Individual
LIFAN FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
60 MDG/SGGE, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1809
(707) 423-3825
Mailing address
60 MDG/SGGE, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1809
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
326931
NY
Other
Enumeration date
04/05/2022
Last updated
07/24/2025
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