Individual provider · Type 1 NPI

Holly K. Fanning, PA

Medical Physician Assistant · La Jolla, CA

NPI number 1104387448 Active

Practice location

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Call (858) 554-7909 Map

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X023260 (NY)
Medical Physician Assistant Primary 363AM0700XPA60834 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1104387448

Holly K. Fanning, PA's National Provider Identifier is 1104387448, issued on Mar 28, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in La Jolla, CA. The record was last updated on Jan 4, 2023.