Sean Fallon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21956 Issued in CA

Practice address

2980 Inland Empire Blvd Unit 102
Ontario, CA 91764-6567

Phone

(760) 286-7826

NPI assigned

Dec 28, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Indian Health Council, Inc

  • Federally Qualified Health Center (FQHC)
  • Valley Center, CA
  • NPI 1861449522
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1396049755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 INLAND EMPIRE BLVD UNIT 102",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 INLAND EMPIRE BLVD UNIT 102",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646567",
            "telephone_number": "760-286-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "SEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-28",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Fajardo
• Yana Nayef Fakhouri
• Farida Fakhry
• Lavinia Faleofa
• Brandy Marie Fall
• Family Foot Center Podiatry Group Inc.
• Family Medical Clinics of California, Inc
• Timothy Fan
• Tingting Fan
• Su-Ching Fann, R.PH.

• Physician Assistant in Ontario, CA
• Providers in Ontario, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.