Provider Demographics
NPI:1407258395
Name:SAN DIEGO ENDOCRINOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:SAN DIEGO ENDOCRINOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALAHATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-485-5301
Mailing Address - Street 1:15611 POMERADO RD
Mailing Address - Street 2:525
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2437
Mailing Address - Country:US
Mailing Address - Phone:858-485-5301
Mailing Address - Fax:858-485-1627
Practice Address - Street 1:15611 POMERADO RD
Practice Address - Street 2:525
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:858-485-5301
Practice Address - Fax:858-485-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty