Philippe Edouard, M.d., Inc. | |
1165 Montgomery Dr Santa Rosa CA 95405-4801 | |
(707) 546-3210 | |
Not Available |
Full Name | Philippe Edouard, M.d., Inc. |
---|---|
Speciality | Internal Medicine |
Location | 1165 Montgomery Dr, Santa Rosa, California |
Authorized Official Name and Position | Philippe Robert Edouard (OWNER) |
Authorized Official Contact | 7073225679 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Philippe Edouard, M.d., Inc. 1275 4th St #371 Santa Rosa CA 95404-4057 Ph: (707) 322-5679 | Philippe Edouard, M.d., Inc. 1165 Montgomery Dr Santa Rosa CA 95405-4801 Ph: (707) 546-3210 |
NPI Number | 1154377109 |
---|---|
Provider Enumeration Date | 05/25/2006 |
Last Update Date | 03/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154377109 | NPI | - | NPPES |
00C512570 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | C51257 (California) | Primary |
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