Healthcare Provider Details

I. General information

NPI: 1356259246
Provider Name (Legal Business Name): FDP PHLEBOTOMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 E MISSION RD
FALLBROOK CA
92028-1761
US

IV. Provider business mailing address

1605 E MISSION RD
FALLBROOK CA
92028-1761
US

V. Phone/Fax

Practice location:
  • Phone: 442-207-2778
  • Fax:
Mailing address:
  • Phone: 442-207-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: FELICIA NEWMAN
Title or Position: CEO
Credential:
Phone: 442-207-2778