Individual
DR. JASON EDWARD EBERHART-PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
931 SPRING ST, PLACERVILLE, CA 95667-4543
(530) 621-6277
Mailing address
PO BOX 2166, PLACERVILLE, CA 95667-2166
(530) 621-6277
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
G66655
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G666550
—
CA
Enumeration date
02/12/2007
Last updated
07/08/2007
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