Individual
REGIS FRANCIS FALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14229 PALISADES DR, POWAY, CA 92064-6461
(858) 679-9201
(858) 486-1741
Mailing address
PO BOX 500030, SAN DIEGO, CA 92150-0030
(858) 679-9201
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G60107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G601070
MEDI-CAL
CA
01
—
G60107
MEDICAL LICENSE CA
CA
Enumeration date
05/11/2007
Last updated
07/08/2007
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