Most Relevant Information
Provider Data
| NPI Number: | 1003364514 |
| Provider Name: | MICHAEL THOMAS FABIAN PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 95008567 |
Most Important Dates
| Enumeration Date: | 09/13/2016 |
| Last Updated: | 10/26/2021 |
Provider Practice Location
1501 HUGHES WAY STE 150
LONG BEACH
CA
908101878
Practice Location Phone/Fax
| Phone: | 3102216336 |
| Fax: | 9167036547 |
Provider Mailing Location
1501 HUGHES WAY STE 150
LONG BEACH
CA
908101878
Provider Mailing Phone/Fax
| Phone: | 3102216336 |
| Fax: |