Individual
DANIAL RAY PHIPPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31764 CASINO DR STE 200, LAKE ELSINORE, CA 92530-2312
(951) 471-4649
Mailing address
31764 CASINO DR STE 200, LAKE ELSINORE, CA 92530-2312
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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