Healthcare Provider Details

I. General information

NPI: 1407963002
Provider Name (Legal Business Name): SHELDON FAYNER M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3356 W BALL RD STE 206
ANAHEIM CA
92804
US

IV. Provider business mailing address

3356 W BALL RD STE 206
ANAHEIM CA
92804-3728
US

V. Phone/Fax

Practice location:
  • Phone: 714-827-8890
  • Fax: 714-827-8905
Mailing address:
  • Phone: 714-827-8890
  • Fax: 714-827-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG34800
License Number StateCA

VIII. Authorized Official

Name: DR. SHELDON RICHARD FAYNER
Title or Position: PRESIDENT
Credential: MD
Phone: 714-827-8890