Individual
PHILIP DOUGLAS FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5255 ELKHORN BLVD, SACRAMENTO, CA 95842-2506
(916) 334-1100
Mailing address
701 HOWE AVE STE C3, SACRAMENTO, CA 95825-4604
(916) 972-1100
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13263
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13263
PA LICSENSE
CA
Enumeration date
12/09/2006
Last updated
03/07/2023
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