Provider Demographics
NPI:1528223278
Name:FANO, ROBERT R (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:FANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:940 HILLTOP DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-3869
Mailing Address - Country:US
Mailing Address - Phone:530-221-1228
Mailing Address - Fax:530-221-1248
Practice Address - Street 1:940 HILLTOP DR
Practice Address - Street 2:SUITE D
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-3869
Practice Address - Country:US
Practice Address - Phone:530-221-1228
Practice Address - Fax:530-221-1248
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008381111N00000X
CO6472111N00000X
CA33109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor