Organization
LAURENCE M FAKINOS, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE M FAKINOS MD (CEO / PHYSICIAN)
(949) 364-3050
Entity
Organization
Contact information
Practice address
27800 MEDICAL CENTER RD, SUITE 260, MISSION VIEJO, CA 92691-6410
(949) 364-3050
(949) 364-2135
Mailing address
27800 MEDICAL CENTER RD, SUITE 260, MISSION VIEJO, CA 92691-6410
(949) 364-3050
(949) 364-2135
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G67377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G6737700
—
CA
Enumeration date
02/29/2012
Last updated
02/29/2012
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