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General NPI Number Information
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NPI Number | 1861181703
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Entity Type | Individual
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Provider Name | SETH FALLEN
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Gender | Male
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 191 E POLK ST
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City | COALINGA
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State | CA
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Zip | 93210-2311
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Country | US
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Telephone | 559-935-2100
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Fax | 559-935-4100
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Provider Business Mailing Address
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Address Line | PO BOX 580
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City | LEMOORE
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State | CA
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Zip | 93245-0580
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Country | US
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Telephone | 559-386-4500
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Fax | 559-282-5090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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