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General NPI Number Information
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NPI Number | 1578510665
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Entity Type | Individual
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Provider Name | PHILLIP E STRUBBE PA
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 4445 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4135
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Country | US
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Telephone | 951-788-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 6792 SUGAR PINE ST
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City | CHINO
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State | CA
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Zip | 91710-7443
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Country | US
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Telephone | 951-741-7076
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Fax | 909-902-0523
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA16045
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License Number State | CA
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