Mary Douglas Fortin in Santa Clara - Pediatrics
Mary Douglas Fortin - NPI 1215091947
Mary Douglas Fortin is a Pediatrics in Santa Clara, California. Mary Douglas Fortin practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Mary Douglas Fortin is 1215091947. The last update date is 2007-07-08.
Mary Douglas Fortin's current location address is 710 Lawerence Expressway, Dept.174, Santa Clara, California. You can contact this provider via phone number 4088511495 and fax number 4088511499. The mailing address for Mary Douglas Fortin is 710 Lawerence Expressway, Dept.174, Santa Clara, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Douglas Fortin |
|---|---|
| Address | 710 Lawerence Expressway, Dept.174, Santa Clara, California |
| Phone Number | 4088511495 |
| Fax Number | 4088511499 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1215091947 |
|---|---|
| Provider Enumeration Date | 2006-12-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 710 Lawerence Expressway, Dept.174 |
|---|---|
| City | Santa Clara |
| State | California (CA) |
| Post Code | 95051 |
| Phone Number | 4088511495 |
| Fax Number | 4088511499 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | PT10606 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Mary Douglas Fortin?
The Mary Douglas Fortin has been issued the NPI (National Provider Identifier) 1215091947 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Mary Douglas Fortin is physically located?
The Mary Douglas Fortin is situated at the following address: 710 Lawerence Expressway, Dept.174, Santa Clara, CA 95051.
What is Mary Douglas Fortin's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Mary Douglas Fortin is Pediatrics, and the taxonomy code that classifies this field of practice is 2251P0200X.
On what date did the Mary Douglas Fortin receive its 1215091947 assignment from the Centers for Medicare & Medicaid Services?
The Mary Douglas Fortin was assigned its 1215091947 by the Centers for Medicare & Medicaid Services on 2006-12-20.
As of what date were the details pertaining to Mary Douglas Fortin last refreshed?
The information related to the Mary Douglas Fortin, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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