MICHAEL K FAIRBANKS DPM NPI 1578678926

NPI Information

NPI: 1578678926
Provider Name: MICHAEL K FAIRBANKS, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
425 W BONITA AVE STE 110
SAN DIMAS, CA
ZIP 91773
Phone: (909) 599-0981
Get Directions

Michael K Fairbanks, DPM is a podiatrist in San Dimas, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Michael K Fairbanks, DPM NPI is 1578678926. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

425 W BONITA AVE STE 110
SAN DIMAS, CA
ZIP 91773-543
Phone: (909) 599-0981

The NPI 1578678926 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 8/19/2006 and was last updated on 12/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		E2726	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000E27260	MEDICAID	CALIFORNIA
2	T19228	MEDICARE UPIN	CALIFORNIA
3	480029085	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	RAILROAD
4	E2726	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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