Individual
GENEVIEVE PHILIPONIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 334-3411
Mailing address
975 S FAIRMONT AVE, LODI, CA 95240-5118
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A169585
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2018
Last updated
01/14/2021
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