MICHAEL M. FANOUS D.P.M. INC. NPI 1083796726

NPI Information

  • NPI: 1083796726
  • Provider Name: MICHAEL M. FANOUS, D.P.M., INC.
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 15366 11TH ST
    SUITE D
    VICTORVILLE, CA
    ZIP 92395
  • Phone: (760) 951-1238

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NPI Details

MICHAEL M. FANOUS, D.P.M., INC. is a foot and ankle surgery podiatrist in Victorville, CA. MICHAEL M. FANOUS, D.P.M., INC. NPI is 1083796726. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15366 11TH ST
SUITE D
VICTORVILLE, CA
ZIP 92395-726
Phone: (760) 951-1238

The provider's authorized official is Michael M. Fanous .
The authorized official title is President and has the following contact phone number (760) 951-1238.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 7/31/2008.

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
1213ES0103XPodiatristFoot & Ankle SurgeryE3544CALIFORNIAYes

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
1T82756MEDICARE UPINCALIFORNIA
2ZZZ02340ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE #
36034990001MEDICARE NSCCALIFORNIA

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: 11/21/2025

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