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NPI Code Detail

MEDICARE: ARRAN FAHEY

MEDICARE: ARRAN FAHEY
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1710833124
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARRAN FAHEY
Provider Business Mailing Address
First Line : 5500 CAMPANILE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92182-0003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5500 CAMPANILE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92182-0003
Country : US
Telephone Number : 619-594-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ ARRAN FAHEY ” Practice Location

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