MEDICARE: NORTH VALLEY NEUROLOGIC ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1124595822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH VALLEY NEUROLOGIC ASSOCIATES

Provider Business Mailing Address
First Line	:	367 DEL NORTE #4
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4116
Country	:	US
Telephone Number	:	530-751-9604
Fax Number	:	530-751-9530

Provider Business Practice Location Address
First Line	:	367 DEL NORTE #4
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4116
Country	:	US
Telephone Number	:	530-751-9604
Fax Number	:	530-751-9530

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. JEFFREY L PHILLIPS
Credential	:	MD
Telephone Number	:	530-751-9604

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	10/31/2018

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