Individual
DR. FADY BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S BLDG 53, ORANGE, CA 92868-3201
(909) 331-1602
Mailing address
12019 HUNTLEY DR, RANCHO CUCAMONGA, CA 91739-2543
(909) 331-1602
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A157668
CA
Other
Enumeration date
06/17/2016
Last updated
05/18/2020
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