Individual
MOHAMMAD FAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5060 ROSEMEAD BLVD, PICO RIVERA, CA 90660-2402
(562) 789-1356
Mailing address
17385 SUMMER OAK PL, YORBA LINDA, CA 92886-9002
(562) 789-1356
(562) 222-2225
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A35835
CA
282N00000X
General Acute Care Hospital
Primary
A35835A
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A358350
BLUE CROSS BLUE SHIELD
CA
Enumeration date
01/08/2008
Last updated
02/26/2010
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