Provider Demographics
NPI:1245598598
Name:FASTIGGI, WILLIAM S (DVM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:FASTIGGI
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7484 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610
Mailing Address - Country:US
Mailing Address - Phone:916-726-2334
Mailing Address - Fax:916-726-2347
Practice Address - Street 1:7484 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610
Practice Address - Country:US
Practice Address - Phone:916-726-2334
Practice Address - Fax:916-726-2347
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA10552174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian