Healthcare Provider Details

I. General information

NPI: 1679400428
Provider Name (Legal Business Name): FAIRCARE HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S JUNIPER ST STE 207
ESCONDIDO CA
92025-4955
US

IV. Provider business mailing address

333 S JUNIPER ST STE 207
ESCONDIDO CA
92025-4955
US

V. Phone/Fax

Practice location:
  • Phone: 619-221-5977
  • Fax: 619-912-0011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ANAS TAREK SALLAM
Title or Position: CEO
Credential:
Phone: 949-331-4843