Healthcare Provider Details

I. General information

NPI: 1730160441
Provider Name (Legal Business Name): ANTHONY F. PHILIPPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD UC DAVIS HEALTH SYSTEM
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2315 STOCKTON BLVD UC DAVIS HEALTH SYSTEM
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5178
  • Fax:
Mailing address:
  • Phone: 916-734-5178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberG85239
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: