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General NPI Number Information
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NPI Number | 1265592901
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Entity Type | Organization
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Legal Business Name | LOREN L. FAABORG, MD, PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 10503 W THUNDERBIRD BLVD SUITE 301
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City | SUN CITY
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State | AZ
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Zip | 85351-3022
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Country | US
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Telephone | 623-974-3647
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Fax | 623-977-0310
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Provider Business Mailing Address
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Address Line | 10503 W THUNDERBIRD BLVD SUITE 301
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City | SUN CITY
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State | AZ
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Zip | 85351-3022
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Country | US
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Telephone | 623-974-3647
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Fax | 623-977-0310
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOREN FAABORG
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Credential | M.D.
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Telephone | 623-974-3647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 33356
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License Number State | AZ
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