NPIMap

Organization Active NPI

C. H. Fagan, M.D., Inc

  • Health Service Clinic/Center
  • Big Bear Lake, CA
National Provider Identifier
1487838074
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
G42774 Issued in CA
Legal business name
C. H. FAGAN, M.D., INC
Practice address
41933 Big Bear Blvd.
Big Bear Lake, CA 92315-6848
Phone
(909) 866-5868
Fax
(909) 866-5860
NPI assigned
Dec 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Christopher Hein Fagan, M.D.
Title
President
Phone
(909) 866-5868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X G42774 CA Primary

Addresses

Primary practice location

41933 Big Bear Blvd.
Big Bear Lake, CA 92315-6848

Mailing address

P. O. Box 6848 PMB 278
Big Bear Lake, CA 92315-6848
Phone (909) 866-5868

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1487838074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 6848 PMB 278",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923156848",
            "telephone_number": "909-866-5868",
            "fax_number": "909-866-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41933 BIG BEAR BLVD.",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923156848",
            "telephone_number": "909-866-5868",
            "fax_number": "909-866-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. H. FAGAN, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "HEIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-866-5868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "G42774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Bear Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.