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NPI Code Detail

MEDICARE: DR. LUIS A. FIALLO M.D., F.A.C.P.

MEDICARE:  DR. LUIS A. FIALLO  M.D., F.A.C.P.
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
1207RP1001XPulmonary Disease PhysicianC51309CA
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianC51309CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21760644686OTHERCAINCORPORATED NPI

General Provider Information

NPI Number : 1407824600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIS A. FIALLO M.D., F.A.C.P.
Provider Business Mailing Address
First Line : 23845 MCBEAN PKWY
Second Line :
City : VALENCIA
State : CA
Zip : 91355-2001
Country : US
Telephone Number : 661-200-1122
Fax Number : 661-200-1119
Provider Business Practice Location Address
First Line : 1415 ROSS AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-4306
Country : US
Telephone Number : 760-339-7202
Fax Number : 760-339-9904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 04/10/2020

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