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Organization
PHILNLN, INC.
Active
Organization
PHILNLN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP JOSEPH CITEK MD (AUTHORIZED OFFICIAL)
(805) 909-0612
Entity
Organization
Contact information
Practice address
7619 MORRO RD, ATASCADERO, CA 93422-4433
(805) 461-9192
(805) 461-5802
Mailing address
10 SANTA ROSA ST, STE 201, SAN LUIS OBISPO, CA 93405-5825
(805) 786-4878
(805) 597-8356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A44775
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
A47889
CA
208VP0014X
Interventional Pain Medicine Physician
A47889
CA
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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