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Individual
DR. STEPHANUS R PHILIP
Active
Individual
DR. STEPHANUS R PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A87363
CA
208000000X
Pediatrics Physician
A87363
CA
208M00000X
Hospitalist Physician
Primary
A87363
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A873630
MCAL PROVIDER NUMBER
CA
01
—
WA87363D
MEDICARE PTAN
CA
Enumeration date
06/17/2006
Last updated
07/17/2023
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