Healthcare Provider Details

I. General information

NPI: 1265462196
Provider Name (Legal Business Name): NATHAN MCFARLAND M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10039 VINE ST
LAKESIDE CA
92040-3130
US

IV. Provider business mailing address

425 N DATE ST
ESCONDIDO CA
92025-3413
US

V. Phone/Fax

Practice location:
  • Phone: 619-390-9975
  • Fax: 619-390-8721
Mailing address:
  • Phone: 760-737-2035
  • Fax: 760-741-2782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA75411
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA75411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: