Phillips, Tracy T

Phillips, Tracy T is an sole proprietor health care provider with primary practice located at 2089 Vale Road Suite 10, San Pablo CA 94806. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Phillips, Tracy T can be contacted via phone (510) 234-4235.

Contact Information

Primary practice address
2089 Vale Road Suite 10 San Pablo CA 94806
Phone: (510) 234-4235
Fax: (510) 215-9863
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A84062 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X A84062 California

Profile Details

NPI number 1558464990
LBN Legal business name Phillips, Tracy T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2006
Last updated Jun 15th, 2020 - about 4 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 1558464990 NPPES
California MEDICAID 00A840620

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