| Big Bear Family Practice Professional Corporation | |
|
41945 Big Bear Blvd Suite 200 Big Bear Lake CA 92315 | |
| (909) 866-6567 | |
| Not Available |
| Full Name | Big Bear Family Practice Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 41945 Big Bear Blvd, Big Bear Lake, California |
| Authorized Official Name and Position | Christopher H. Fagan (OWNER) |
| Authorized Official Contact | 9098666567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Bear Family Practice Professional Corporation Po Box 1656 Big Bear Lake CA 92315-1656 Ph: (909) 866-6567 | Big Bear Family Practice Professional Corporation 41945 Big Bear Blvd Suite 200 Big Bear Lake CA 92315 Ph: (909) 866-6567 |
| NPI Number | 1225543473 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 01/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225543473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G42774 (California) | Primary |
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