Mystical Rose Obstetrics And Gynecology
Obstetrics & Gynecology in Fallbrook, CA. Organization (NPI-2).
NPI number1851521231
StatusActive
Last updated in NPPESDec 21, 2021
Details
- NPI
- 1851521231
- Entity type
- Organization (NPI-2)
- Legal business name
- Mystical Rose Obstetrics And Gynecology
- Organization subpart
- No
- Enumeration date
- Jul 21, 2009
- Certification date
- Dec 21, 2021
- Last updated
- Dec 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | – | – | Yes |
Practice location
577 E Elder St Ste KFallbrook, CA 92028-3079
Phone 760-983-4024 · Fax 760-723-9010
Mailing address
577 E Elder St Ste KFallbrook, CA 92028-3079
Phone 760-983-4024 · Fax 760-723-9010
Other practice locations
Authorized official
Shilo Stigen
Chief Financial Officer
6193184798
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