# MYSTICAL ROSE OBSTETRICS AND GYNECOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851521231
- **Authorized official:** SHILO STIGEN (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (619) 318-4798

## Contact information

- **Practice address:** 577 E ELDER ST STE K, FALLBROOK, CA 92028-3079
- **Practice address phone:** (760) 983-4024
- **Practice address fax:** (760) 723-9010
- **Mailing address:** 577 E ELDER ST STE K, FALLBROOK, CA 92028-3079
- **Mailing address phone:** (760) 983-4024
- **Mailing address fax:** (760) 723-9010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 12/21/2021