Provider Demographics
NPI:1932219169
Name:PROANO, FABIAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:FABIAN
Middle Name:A
Last Name:PROANO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3701 SKYPARK DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4753
Mailing Address - Country:US
Mailing Address - Phone:310-791-4980
Mailing Address - Fax:310-791-4989
Practice Address - Street 1:3701 SKYPARK DR
Practice Address - Street 2:SUITE 260
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4753
Practice Address - Country:US
Practice Address - Phone:310-791-4980
Practice Address - Fax:310-791-4989
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-07-30
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Provider Licenses
StateLicense IDTaxonomies
CAG55631207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE47628Medicare UPIN