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NPI Code Detail

MEDICARE: PHOENIX GERMANO

MEDICARE: PHOENIX GERMANO
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1801578851
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHOENIX GERMANO
Provider Business Mailing Address
First Line : 20548 VENTURA BLVD APT 407
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-6472
Country : US
Telephone Number : 310-721-4398
Fax Number :
Provider Business Practice Location Address
First Line : 1316 APACHE AVE
Second Line :
City : SANTA FE
State : NM
Zip : 87505-3212
Country : US
Telephone Number : 310-721-4398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2023
Last Update Date : 11/22/2024

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Directions to “ PHOENIX GERMANO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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