MEDICARE: DR. MARK STEVEN FALCONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0002X	Emergency Care Clinic/Center	G27608	CA

General Provider Information

NPI Number	:	1083057251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK STEVEN FALCONE M.D.

Provider Business Mailing Address
First Line	:	2 S ALTA MIRA RD
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-6712
Country	:	US
Telephone Number	:	949-499-6283
Fax Number	:	949-499-6583

Provider Business Practice Location Address
First Line	:	2 S ALTA MIRA RD
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-6712
Country	:	US
Telephone Number	:	949-499-6283
Fax Number	:	949-499-6583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	04/08/2013

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