DERRICK AUSTIN FAMA SY

RANCHO MIRAGE, CA
NPI1124821145
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2025-03-27
Last Update Date2025-03-27
Business Address
DERRICK AUSTIN FAMA SY DO
39000 BOB HOPE DR
RANCHO MIRAGE, CA 92270-3221
Phone number: 760-773-2968
Mailing Address
DERRICK AUSTIN FAMA SY DO
39000 BOB HOPE DR STE 201
RANCHO MIRAGE, CA 92270-3221
Phone number: