Individual
SANDRA PHILOMENA FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2020 SANTA MONICA BLVD, SUITE 580, SANTA MONICA, CA 90404-2023
(310) 453-4455
(310) 453-8833
Mailing address
2020 SANTA MONICA BLVD, SUITE 580, SANTA MONICA, CA 90404-2023
(310) 453-4455
(310) 453-8833
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A46060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A46060
CA STATE LICENSE
CA
01
—
WA46060E
PPIN
CA
Enumeration date
01/13/2007
Last updated
01/21/2011
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