Provider Demographics
NPI:1962892059
Name:JULIET E FLIEGEL, MD
Entity type:Organization
Organization Name:JULIET E FLIEGEL, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-885-1679
Mailing Address - Street 1:13603 MAR SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3424
Mailing Address - Country:US
Mailing Address - Phone:619-885-1679
Mailing Address - Fax:619-839-3980
Practice Address - Street 1:13603 MAR SCENIC DR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3424
Practice Address - Country:US
Practice Address - Phone:619-885-1679
Practice Address - Fax:619-839-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG84603OtherLICENSE