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1861498271

NPI Code Detail

MEDICARE: MARWAN G FAKIH MD

MEDICARE: MARWAN G FAKIH 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	207R00000X	Internal Medicine Physician	4301059972	MI
2	207RH0003X	Hematology & Oncology Physician	224776	NY
3	207RX0202X	Medical Oncology Physician	4301059972	MI
4	207RX0202X	Medical Oncology Physician	C55385	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	:	1861498271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARWAN G FAKIH MD

Provider Business Mailing Address
First Line	:	1333S MAYFLOWER AVE 2
Second Line	:
City	:	MONROVIA
State	:	CA
Zip	:	91016-4066
Country	:	US
Telephone Number	:	626-775-3514
Fax Number	:	626-408-3911

Provider Business Practice Location Address
First Line	:	1500 DUARTE RD
Second Line	:
City	:	DUARTE
State	:	CA
Zip	:	91010-3012
Country	:	US
Telephone Number	:	626-359-8111
Fax Number	:

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/10/2020

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Directions to “ MARWAN G FAKIH MD” Practice Location

Language	Start Address	Practice Location

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