Healthcare Provider Details

I. General information

NPI: 1336827211
Provider Name (Legal Business Name): FICAREMED PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15644 POMERADO RD STE 100
POWAY CA
92064-2419
US

IV. Provider business mailing address

15644 POMERADO RD STE 100
POWAY CA
92064-2419
US

V. Phone/Fax

Practice location:
  • Phone: 858-485-5111
  • Fax: 858-485-6747
Mailing address:
  • Phone: 858-485-5111
  • Fax: 858-485-6747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATROCINIA MAGAT
Title or Position: OWNER
Credential: MD
Phone: 959-485-5111