Healthcare Provider Details

I. General information

NPI: 1164900312
Provider Name (Legal Business Name): PHILLIP FRANGIE RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PHILLIP A. FRANGIE RCP

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 PALM AVE
SAN DIEGO CA
92154-8404
US

IV. Provider business mailing address

803 VISTA WAY
CHULA VISTA CA
91911-1419
US

V. Phone/Fax

Practice location:
  • Phone: 619-662-5489
  • Fax:
Mailing address:
  • Phone: 619-213-8016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number6312
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: