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1306344122
STEPHANIE LYNN FANOUS
EL SEGUNDO, CA
NPI
1306344122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95008438)
Enumeration Date
2018-01-26
Last Update Date
2018-01-26
Business Address
STEPHANIE LYNN FANOUS NP
2175 PARK PL
EL SEGUNDO, CA 90245-4705
Phone number: 310-354-4318
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Mailing Address
STEPHANIE LYNN FANOUS NP
1286 BONNIE BRAE ST
HERMOSA BEACH, CA 90254-4028
Phone number: 310-963-5719
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