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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508892696 NPPES
California MEDICAID 9867

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