Individual
PHYLLIS JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 EL CAMINO REAL, SOUTH SAN FRANCISCO, CA 94080-3208
(650) 742-2100
(650) 742-1311
Mailing address
901 EL CAMINO REAL, SAN BRUNO, CA 94066-3009
(650) 742-2100
(650) 742-1311
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
193145
CA
Other
Enumeration date
01/03/2007
Last updated
07/11/2007
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