Healthcare Provider Details
I. General information
NPI: 1245680990
Provider Name (Legal Business Name): JOSEPH FALCONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/14/2016
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 CHILDRENS LN
NORFOLK VA
23507-1910
US
IV. Provider business mailing address
101 THE CITY DR S BUILDING 200, SUITE 210
ORANGE CA
92868-3201
US
V. Phone/Fax
- Phone: 757-668-7990
- Fax: 757-668-7995
- Phone: 714-456-6966
- Fax: 714-456-8212
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | 0101282444 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: