Individual
DR. MICHAEL JOSEPH FAZIO
Active
Individual
DR. MICHAEL JOSEPH FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G059079
CA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
G059079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0615441
CLIA
CA
Enumeration date
06/24/2005
Last updated
03/26/2025
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