Individual
ALEXIS FAGUNDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(626) 566-8501
Mailing address
3936 PARK PL, MONTROSE, CA 91020-1609
(818) 261-7059
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95027346
CA
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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