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NPI Code Detail

MEDICARE: MR. FLANAGAN WHITSITT PA

MEDICARE:  MR. FLANAGAN  WHITSITT  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistPA16888CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WPA16888AOTHERCAMEDICARE PPIN

General Provider Information

NPI Number : 1134294382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FLANAGAN WHITSITT PA
Provider Business Mailing Address
First Line : 6641 SAN ANGELO AVE
Second Line :
City : JOSHUA TREE
State : CA
Zip : 92252-2225
Country : US
Telephone Number : 760-366-9773
Fax Number : 951-695-3949
Provider Business Practice Location Address
First Line : 6641 SAN ANGELO AVE
Second Line :
City : JOSHUA TREE
State : CA
Zip : 92252-2225
Country : US
Telephone Number : 760-366-9773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 12/03/2007

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Directions to “ MR. FLANAGAN WHITSITT PA” Practice Location

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