Obstetrics & Gynecology Li Fan MD Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

C132851 Issued in CA

Legal business name

OBSTETRICS & GYNECOLOGY LI FAN MD INC

Practice address

15725 Pomerado Rd Ste 207
Poway, CA 92064-2059

Phone

(858) 451-7944

NPI assigned

Jul 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Li Fan, M.D.NPI 1730282658

Title

President

Phone

(858) 451-7944

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Li Fan, M.D.

  • Obstetrics & Gynecology Physician
  • Poway, CA
  • NPI 1730282658
  Medicare reassignment Authorized official
• Timothy Maresh, MD

  • Obstetrics & Gynecology Physician
  • Poway, CA
  • NPI 1245339985
  NPD

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1588047849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 POMERADO ROAD",
            "address_2": "STE 207",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-451-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD STE 207",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642059",
            "telephone_number": "858-451-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS & GYNECOLOGY LI FAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FAN",
        "authorized_official_first_name": "LI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-451-7944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "C132851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Nussbaum, M.D.
• Nutriwise Health LLC
• Jacob O'Brien
• Ciara O'Quigley
• Rinka Oba
• Elsie Ochoa
• Destiny Okoronkwo
• Alexis Oliver
• Kimberly Olmedo
• Ruben Olmos

• Medical Specialty Clinic/Center in Poway, CA
• Providers in Poway, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.