Healthcare Provider Details

I. General information

NPI: 1710352042
Provider Name (Legal Business Name): FAIRCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1089 LOS ALTOS AVE
LOS ALTOS CA
94022-1018
US

IV. Provider business mailing address

1089 LOS ALTOS AVE
LOS ALTOS CA
94022-1018
US

V. Phone/Fax

Practice location:
  • Phone: 650-862-0439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC DUPRAT
Title or Position: CEO
Credential:
Phone: 650-862-0439