MEDICARE: PHILIP F CONFER IDC

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	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1821059098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP F CONFER IDC

Provider Business Mailing Address
First Line	:	2450 CRAVEN ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92136-5599
Country	:	US
Telephone Number	:	619-556-8114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 CRAVEN ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92136-5599
Country	:	US
Telephone Number	:	619-556-8114
Fax Number	:

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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Directions to “ PHILIP F CONFER IDC” Practice Location

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