Ethan Rudnick Faye, MD
Student in an Organized Health Care Education/Training Program in Riverside, CA. Individual provider (NPI-1).
NPI number1801655352
StatusActive
Last updated in NPPESMar 18, 2024
Details
- NPI
- 1801655352
- Entity type
- Individual (NPI-1)
- Name
- Ethan Rudnick Faye
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 18, 2024
- Certification date
- Mar 17, 2024
- Last updated
- Mar 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
4445 Magnolia AveRiverside, CA 92501-4135
Phone 951-897-9896
Mailing address
4445 Magnolia AveRiverside, CA 92501-4135
Phone 951-897-9896
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