Individual
MRS. SARA KATHLEEN FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103
(800) 926-8273
(888) 539-8781
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-760
ID
363AS0400X
Surgical Physician Assistant
Primary
51668
CA
Other
Enumeration date
09/08/2008
Last updated
06/10/2019
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