Individual
MRS. CATHY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
720 E LATHAM AVE STE 1, HEMET, CA 92543-4371
(951) 658-9461
Mailing address
720 E LATHAM AVE STE 1, HEMET, CA 92543-4371
(951) 658-9461
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z73069
MEDICARE PROVIDER NUMBER
AZ
Enumeration date
12/07/2011
Last updated
09/06/2012
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