Healthcare Provider Details

I. General information

NPI: 1841628641
Provider Name (Legal Business Name): FALLBROOK HEALTHCARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 E ELDER ST SUITE 591C
FALLBROOK CA
92028-5001
US

IV. Provider business mailing address

591 E ELDER ST SUITE 591C
FALLBROOK CA
92028-5001
US

V. Phone/Fax

Practice location:
  • Phone: 760-731-8989
  • Fax:
Mailing address:
  • Phone: 760-731-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA ARWOOD
Title or Position: DIRECTOR
Credential:
Phone: 615-628-6038