MEDICARE: HILARY J FAUSETT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	G85360	CA
2	208VP0014X	Interventional Pain Medicine Physician	G85360	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861468134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILARY J FAUSETT MD

Provider Business Mailing Address
First Line	:	39 CONGRESS ST
Second Line	:	#303
City	:	PASADENA
State	:	CA
Zip	:	91105-3024
Country	:	US
Telephone Number	:	626-440-5900
Fax Number	:	626-440-5900

Provider Business Practice Location Address
First Line	:	39 CONGRESS ST
Second Line	:	#303
City	:	PASADENA
State	:	CA
Zip	:	91105-3024
Country	:	US
Telephone Number	:	626-440-5900
Fax Number	:	626-440-5900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	01/09/2020

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