Mitchell Thomas Fallon, PA-C
Physician Assistant in Newport Beach, CA. Individual provider (NPI-1).
NPI number1720366255
StatusActive
Last updated in NPPESApr 8, 2025
Details
- NPI
- 1720366255
- Entity type
- Individual (NPI-1)
- Name
- Mitchell Thomas Fallon
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 2, 2011
- Certification date
- Apr 8, 2025
- Last updated
- Apr 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA21619 | CA | Yes |
Practice location
520 Superior Ave Ste 300Newport Beach, CA 92663-3668
Phone 949-764-1411
Mailing address
520 Superior Ave Ste 300Newport Beach, CA 92663-3668
Phone 949-764-1411
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