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Individual

ROYA FATHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
28901 CANMORE ST, AGOURA HILLS, CA 91301-1716
(312) 351-0420
Mailing address
28901 CANMORE ST, AGOURA HILLS, CA 91301-1716
(312) 351-0420

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A124602
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
C12-0000037
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801104179
NPI
CA
Enumeration date
09/20/2010
Last updated
04/25/2024
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