Individual
PHILLIP ALAN MISHAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
9056 PINTO CANYON WAY, ROSEVILLE, CA 95747-7108
(251) 434-8000
Mailing address
9056 PINTO CANYON WAY, ROSEVILLE, CA 95747-7108
(251) 434-8000
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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