Organization
FAIRMOUNT MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED T BAILONY M.D. (OWNER)
(619) 475-9174
Entity
Organization
Contact information
Practice address
4074 FAIRMONT AVE, SAN DIEGO, CA 92105-1608
(619) 325-1819
Mailing address
4074 FAIRMONT AVE, SAN DIEGO, CA 92105-1608
(619) 325-1819
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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