Healthcare Provider Details

I. General information

NPI: 1659725562
Provider Name (Legal Business Name): REBECCA DIANE-FINK CREEKMORE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA DIANE FINK MD

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 CUYAMACA ST STE 101
SANTEE CA
92071-2692
US

IV. Provider business mailing address

9600 CUYAMACA ST STE 101
SANTEE CA
92071-2692
US

V. Phone/Fax

Practice location:
  • Phone: 619-749-2150
  • Fax:
Mailing address:
  • Phone: 619-749-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA159345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: