Mr. Douglas John Fantazia
Nurse Practitioner - Neonatal (Critical Care)
11234 Anderson St
Loma Linda
, California 92354-2804
Mr. Douglas John Fantazia
Nurse Practitioner - Neonatal (Critical Care)
11234 Anderson St
Loma Linda
, California 92354-2804
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About
Features
Specialties
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Mr. Douglas John Fantazia
- 1433 Diamond Ct
- Redlands, CA
- Zip : 92374-5435
- Phone :
Second Address
- Mr. Douglas John Fantazia
- 11234 Anderson St
- Loma Linda, CA
- Zip : 92354-2804
- Phone : (909) 558-4000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 258858 | CA |
National Provider Identifier
| NPI | 1366587685 |
|---|---|
| Provider Name | Mr. Douglas John Fantazia |
| First Address | Redlands, CA 92374-5435 |
| Second Address | Loma Linda, CA 92354-2804 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.