Healthcare Provider Details

I. General information

NPI: 1508126178
Provider Name (Legal Business Name): RHEA M PHILLIPS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 05/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HYDE ST SUITE 609
SAN FRANCISCO CA
94109-4822
US

IV. Provider business mailing address

PO BOX 31001-1870
PASADENA CA
91110-1870
US

V. Phone/Fax

Practice location:
  • Phone: 415-796-3371
  • Fax: 415-829-8897
Mailing address:
  • Phone: 415-796-3371
  • Fax: 415-829-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberC54003
License Number StateCA

VIII. Authorized Official

Name: DR. RHEA M PHILLIPS
Title or Position: PROVIDER/OWNER
Credential: MD
Phone: 415-796-3371