Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marie Louise Fagan, IDC

Individual provider Military Health Care Provider · NPI 1104261726

Marie Louise Fagan, IDC is a Military Health Care Provider in San Diego, California. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

4077 32nd St Apt 8
San Diego, CA 92104-2080
Phone: (678) 764-4067
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Military Health Care Provider (primary) Taxonomy 171000000X

Record details

NPI number1104261726
Entity typeIndividual (Type 1)
GenderFemale
Credentials IDC
Sole proprietorYes
NPI enumeratedMay 9, 2013
Last updated in NPPESMay 9, 2013

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