Polido, Phillip Willie Tan

Polido, Phillip Willie Tan is an individual health care provider with primary practice located at 2350 Country Hills Dr Ste A , Antioch CA 94509-7436. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Polido, Phillip Willie Tan can be contacted via phone (925) 757-0800.

Contact Information

Primary practice address
2350 Country Hills Dr Ste A Antioch CA 94509-7436
Phone: (925) 757-0800
Fax: (925) 757-2160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A32794 California

Profile Details

NPI number 1245320001
LBN Legal business name Polido, Phillip Willie Tan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Feb 12th, 2021 - about 5 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 1245320001 NPPES
California MEDICAID 00A327940
California Other 020008734

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