Provider Demographics
NPI:1588750152
Name:FALCON, MONICA (PA-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FALCON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2828
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878-2828
Mailing Address - Country:US
Mailing Address - Phone:951-278-8870
Mailing Address - Fax:951-278-8913
Practice Address - Street 1:3660 PARK SIERRA DR
Practice Address - Street 2:SUITE 105
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3081
Practice Address - Country:US
Practice Address - Phone:951-278-8870
Practice Address - Fax:951-278-8913
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16804363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P80877Medicare UPIN