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Organization
PHILIPPE EDOUARD, M.D., INC.
Active
Organization
PHILIPPE EDOUARD, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIPPE ROBERT EDOUARD M.D. (OWNER)
(707) 322-5679
Entity
Organization
Contact information
Practice address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 546-3210
Mailing address
1275 4TH ST, #371, SANTA ROSA, CA 95404-4057
(707) 322-5679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C51257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C512570
—
CA
Enumeration date
05/25/2006
Last updated
03/24/2008
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