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General NPI Number Information
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NPI Number | 1083848501
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Entity Type | Organization
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Legal Business Name | MGF SURGERY, AMC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 521 E ELDER ST SUITE 202
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City | FALLBROOK
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State | CA
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Zip | 92028-3081
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Country | US
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Telephone | 760-723-1100
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Fax | 760-723-2180
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Provider Business Mailing Address
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Address Line | 521 E ELDER ST SUITE 202
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City | FALLBROOK
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State | CA
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Zip | 92028-3081
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Country | US
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Telephone | 760-723-1100
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Fax | 760-723-2180
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Authorized Official
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Title or Position | BILLING, CREDENTIALING, CONTRACTING
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Name | MRS. PAMELA A LEHMAN
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Credential |
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Telephone | 951-215-1889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G46300
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License Number State | CA
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