Organization
PHILLIP RAY ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN GIBSON B.A. (MANAGING MEMBER/OWNER)
(916) 761-8385
Entity
Organization
Contact information
Practice address
5711 59TH ST, SACRAMENTO, CA 95824-1815
(916) 737-0173
(916) 737-0174
Mailing address
5711 59TH ST, SACRAMENTO, CA 95824-1815
(916) 737-0173
(916) 737-0174
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
347002410
CA
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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