Organization
LUIS A FIALLO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS A FIALLO MD FACP FCC (MD OWNER)
(619) 421-4000
Entity
Organization
Contact information
Practice address
754 MEDICAL CENTER CT, 100, CHULA VISTA, CA 91911-6655
(619) 421-4000
(619) 421-6395
Mailing address
754 MEDICAL CENTER CT, 100, CHULA VISTA, CA 91911-6655
(619) 450-9960
(619) 773-7956
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C513090
—
CA
01
—
1407824600
NPI
CA
Enumeration date
07/01/2008
Last updated
01/24/2012
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