Da Visio, Philip M.

Da Visio, Philip M. is an individual health care provider with primary practice located at 525 W Acacia St , Stockton CA 95203-2405. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Emergency Medical Service Providers / Personal Emergency Response Attendant. Emergency Medical Service Providers / Personal Emergency Response Attendant is his primary health care specialty. Da Visio, Philip M. can be contacted via phone (209) 944-5550.

Contact Information

Primary practice address
525 W Acacia St Stockton CA 95203-2405
Phone: (209) 944-5550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA17470 California
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X PA17470 California

Profile Details

NPI number 1659380699
LBN Legal business name Da Visio, Philip M.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated Jan 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659380699 NPPES
California MEDICAID PA17470

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