Fallbrook-Rancho Surgery a Medical Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

FALLBROOK-RANCHO SURGERY A MEDICAL CORPORATION

Practice address

1617 Joshua Tree LN
Fallbrook, CA 92028-4334

Phone

(951) 698-4650

Fax

(951) 698-4651

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Robert Nicolas Keenan, M.D.

Title

President

Phone

(951) 698-4650

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melvyn J Michaelian, M.D.

  • Surgery Physician
  • Fallbrook, CA
  • NPI 1427053438
  NPD (past)
• Daniel Oh, M.D.

  • Surgery Physician
  • Santa Maria, CA
  • NPI 1891790614
  NPD (past)
• Joel D Myers, D.O.

  • Surgery Physician
  • Beaufort, SC
  • NPI 1215929716
  NPD (past)
• Patrick P Ting, MD

  • Surgery Physician
  • Lafayette, CO
  • NPI 1457488454
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1437174240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 S MISSION RD STE 408",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284006",
            "telephone_number": "951-698-4650",
            "fax_number": "951-698-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 JOSHUA TREE LN",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284334",
            "telephone_number": "951-698-4650",
            "fax_number": "951-698-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLBROOK-RANCHO SURGERY A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "NICOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-698-4650",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN BLUE SHIELD",
            "identifier": "YYY49687Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHERN BLUE SHIELD",
            "identifier": "ZZZ27707Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0081510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fallbrook Pharmacy Inc II
• Fallbrook Podiatry, Inc
• Fallbrook Spine Center
• Fallbrook Union Elementary School District
• Fallbrook Union High School District
• FDP Phlebotomy LLC
• Fiamengo & Associates Mental Health Counseling and Coaching
• Patricia Joanne Fiamengo, LCSW, M-RAS
• Nancy A Findlay, OTR
• Caitlin Fitzharris

• Surgery Physician in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.