Fallbrook Podiatry, Inc

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

E4987 Issued in CA

Legal business name

FALLBROOK PODIATRY, INC

Practice address

407 Potter St Ste a
Fallbrook, CA 92028-3086

Phone

(760) 728-4800

Fax

(760) 728-0061

NPI assigned

Aug 16, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Grigoriy N Patish, DPMNPI 1609817535

Title

Owner/Provider

Phone

(760) 728-4800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Grigoriy N Patish, DPM

  • Primary Podiatric Medicine Podiatrist
  • Fallbrook, CA
  • NPI 1609817535

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1861825523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 POTTER ST STE A",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283086",
            "telephone_number": "760-728-4800",
            "fax_number": "760-728-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 POTTER ST STE A",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283086",
            "telephone_number": "760-728-4800",
            "fax_number": "760-728-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLBROOK PODIATRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-16",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "PATISH",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "760-728-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E4987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fallbrook Pediatrics, Apc
• Fallbrook Pharmacy Inc II
• Fallbrook Spine Center
• Fallbrook Union Elementary School District
• Fallbrook Union High School District
• Fallbrook-Rancho Surgery a Medical Corporation
• FDP Phlebotomy LLC

• Primary Podiatric Medicine Podiatrist in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.