Individual
WILLIAM FAZZALARO
Active
Individual
WILLIAM FAZZALARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16754
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750339479
GROUP NPI
CA
01
—
PA16754
LICENSE
CA
Enumeration date
12/06/2006
Last updated
02/26/2025
Update your record
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