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NPI Code Detail

MEDICARE: STEFANIE JILL FIGHTLIN DO

MEDICARE: STEFANIE JILL FIGHTLIN DO
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
1207Q00000XFamily Medicine Physician20A7879CA

General Provider Information

NPI Number : 1386640746
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFANIE JILL FIGHTLIN DO
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 26991 CROWN VALLEY PKWY
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-6528
Country : US
Telephone Number : 949-582-5430
Fax Number : 949-348-9513
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 11/16/2025

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