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1275639098
LEE MARSHALL FAGEN
BERKELEY, CA
NPI
1275639098
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: CA RN373234, NP7501)
Enumeration Date
2006-09-16
Last Update Date
2007-07-08
Business Address
-- LEE MARSHALL FAGEN NP
2222 BANCROFT EXT
BERKELEY, CA 94720-4303
Phone number: 510-643-9135
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Mailing Address
-- LEE MARSHALL FAGEN NP
2727 HILLEGASS AVE
BERKELEY, CA 94705-1206
Phone number: 510-843-5326
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