Etchells, Philip Tanner

Etchells, Philip Tanner is an sole proprietor health care provider with primary practice located at 13692 Apple Valley Rd # 170, Apple Valley CA 92308. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Etchells, Philip Tanner can be contacted via phone (760) 961-1919.

Contact Information

Primary practice address
13692 Apple Valley Rd # 170 Apple Valley CA 92308
Phone: (760) 961-1919
Fax: (760) 961-1907
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5518T California

Profile Details

NPI number 1245348465
LBN Legal business name Etchells, Philip Tanner
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2006
Last updated May 2nd, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245348465 NPPES
California MEDICAID SD005181

Popular Providers