Mallory, Phillip A
Mallory, Phillip A is an individual health care provider with primary practice located at 500 W Hospital Rd , French Camp CA 95231-9693. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Mallory, Phillip A can be contacted via phone (209) 468-6300.Contact Information
Primary practice address
500 W Hospital Rd
French Camp CA 95231-9693
Phone: (209) 468-6300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 488728 | California |
Profile Details
| NPI number | 1508892696 |
|---|---|
| LBN Legal business name | Mallory, Phillip A |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Jun 12th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508892696 | NPPES |
| California | MEDICAID | 9867 |
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