Organization
FALLBROOK PODIATRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRIGORIY N PATISH DPM (OWNER/PROVIDER)
(760) 728-4800
Entity
Organization
Contact information
Practice address
407 POTTER ST STE A, FALLBROOK, CA 92028-3086
(760) 728-4800
(760) 728-0061
Mailing address
407 POTTER ST STE A, FALLBROOK, CA 92028-3086
(760) 728-4800
(760) 728-0061
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E4987
CA
Other
Enumeration date
08/16/2013
Last updated
03/08/2021
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