CHARLES PHILLIP ANDREW FAGAN

AZUSA, CA
NPI1720466626
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2015-05-12
Last Update Date2015-05-12
Business Address
Mr. CHARLES PHILLIP ANDREW FAGAN
23701 E EAST FORK RD
AZUSA, CA 91702-1477
Phone number: 626-250-3290
Mailing Address
Mr. CHARLES PHILLIP ANDREW FAGAN
1090 FREMONT ST
POMONA, CA 91766-5028
Phone number: 909-631-7386
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