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General NPI Number Information
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NPI Number | 1528405503
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Entity Type | Individual
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Provider Name | JOSHUA SETH PHILP
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Gender | Male
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 1695 MERRILL DR
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City | SAN JOSE
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State | CA
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Zip | 95124-5919
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Country | US
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Telephone | 585-802-2098
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 MERRILL DR
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City | SAN JOSE
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State | CA
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Zip | 95124-5919
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Country | US
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Telephone | 585-802-2098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 242T00000X
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Taxonomy Name | Perfusionist
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License Number | 02231981J
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License Number State | CA
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