Healthcare Provider Details

I. General information

NPI: 1326240805
Provider Name (Legal Business Name): DAVID WILLIAM FABI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 4TH AVE SUITE 700
SAN DIEGO CA
92103-2181
US

IV. Provider business mailing address

4060 4TH AVE SUITE 700
SAN DIEGO CA
92103-2181
US

V. Phone/Fax

Practice location:
  • Phone: 619-299-8500
  • Fax: 619-297-1443
Mailing address:
  • Phone: 619-299-8500
  • Fax: 619-297-1443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA112916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: