FAZILATH FATIMA (NPI# 1962429571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962429571 |
| Entity Type | Individual |
| Full Name | FAZILATH FATIMA |
| Credential | MD |
| Practice Address |
17360 Brookhurst St Fountain Valley CA 92708-3720 |
| Mailing Address |
17360 Brookhurst St Attn: Credentialing Department Fountain Valley CA 92708-3720 |
| Practice Telephone | 6572413592 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | C133691 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 4301079615 | MI | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 35.097068 | OH | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | C133691 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 4301079615 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 5178262-10 | 05 | |
| MI | NPI | 1962429571 | 01 |
| MI | BCBS CPIN | 70-0-F32947-0 | 01 |
| Street Address |
17360 BROOKHURST ST |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-3720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952300261 | Mahmood Mirbagheri | Internal Medicine | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2005-07-19 |
| 1932727245 | Jessica Wilson | Dietitian, Registered | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2020-07-13 |
| 1578119798 | Francie Thu Nguyen | Pharmacist | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2019-08-13 |
| 1922654144 | Nina Kang | Pharmacist | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2019-08-13 |
| 1992275093 | Behnaz Babaknia | Physician Assistant | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2018-11-30 |
| 1336670728 | Samiya Hussain | Internal Medicine | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2017-03-27 |
| 1134650922 | Eddie Ly | Internal Medicine | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2017-03-23 |
| 1538600317 | Sarah Dabagh | Pediatrics | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2017-03-14 |
| 1609315134 | Brett Bates | Student in an Organized Health Care Education/Training Program | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2017-02-16 |
| 1861855827 | Michael Kraig Benefiel | Internal Medicine | 17360 Brookhurst St, Fountain Valley, CA 92708-3720 | 2016-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194246934 | Georgina Adela Marquez | Internal Medicine | 18300 Euclid St, Fountain Valley, CA 92708-6114 | 2017-07-02 |
| 1932447893 | Roopa Dillikar | Internal Medicine | 11180 Warner Ave Ste 167, Fountain Valley, CA 92708 | 2013-01-27 |
| 1720344880 | Abdulkareem Sharaf | Internal Medicine | 11100 Warner Ave Ste 116, Fountain Valley, CA 92708-7500 | 2012-04-03 |
| 1548526619 | Alan Justin Viglione | Internal Medicine | 9900 Talbert Ave Ste 302, Fountain Valley, CA 92708-5153 | 2012-04-03 |
| 1841594256 | Victor B. Siew, M.d., Inc | Internal Medicine | 17220 Newhope St Ste 125, Fountain Valley, CA 92708-4283 | 2010-12-28 |
| 1497068688 | David Deguire Chan | Internal Medicine | 10840 Warner Ave Ste 103, Fountain Valley, CA 92708-3847 | 2010-07-16 |
| 1316177462 | Phong Huy Bui | Internal Medicine | 16055 Brookhurst St, Suite #c, Fountain Valley, CA 92708 | 2009-07-23 |
| 1427285394 | Hoa Hieu Nguyen | Internal Medicine | 18173 Santa Adela Cir, Fountain Valley, CA 92708-5608 | 2009-06-17 |
| 1780835801 | Steven Le | Internal Medicine | 11100 Warner Ave Ste 114, Fountain Valley, CA 92708-7500 | 2008-10-07 |
| 1669644951 | Tuan Anh Nguyen | Internal Medicine | 11180 Warner Ave Ste 457, Fountain Valley, CA 92708 | 2008-03-27 |
| Find all providers in FOUNTAIN VALLEY | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.