LEE MARSHALL FAGEN

BERKELEY, CA
NPI1275639098
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: CA  RN373234, NP7501)
Enumeration Date2006-09-16
Last Update Date2007-07-08
Business Address
-- LEE MARSHALL FAGEN NP
2222 BANCROFT EXT
BERKELEY, CA 94720-4303
Phone number: 510-643-9135
Mailing Address
-- LEE MARSHALL FAGEN NP
2727 HILLEGASS AVE
BERKELEY, CA 94705-1206
Phone number: 510-843-5326
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