Provider Demographics
NPI:1154308351
Name:FAIX, DENNIS (MD, MPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:FAIX
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4894 EASTCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2753
Mailing Address - Country:US
Mailing Address - Phone:858-342-0872
Mailing Address - Fax:
Practice Address - Street 1:3235 ALBACORE ALY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-5199
Practice Address - Country:US
Practice Address - Phone:619-556-7070
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI395400202083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine