MEDICARE: DR. KAREN M. PHILIPPI M.D.

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
1	207P00000X	Emergency Medicine Physician	G045775	CA

General Provider Information

NPI Number	:	1801819479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN M. PHILIPPI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1020
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95201-3120
Country	:	US
Telephone Number	:	209-468-6937
Fax Number	:	209-468-7042

Provider Business Practice Location Address
First Line	:	500 W HOSPITAL RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-9989
Country	:	US
Telephone Number	:	209-468-6937
Fax Number	:	209-468-7042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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