Phillip Alan Mishaga, IDC
Military Health Care Provider, Independent Duty Corpsman in Roseville, CA. Individual provider (NPI-1).
NPI number1649600321
StatusActive
Last updated in NPPESNov 18, 2013
Details
- NPI
- 1649600321
- Entity type
- Individual (NPI-1)
- Name
- Phillip Alan Mishaga
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 18, 2013
- Last updated
- Nov 18, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
9056 Pinto Canyon WayRoseville, CA 95747-7108
Phone 251-434-8000
Mailing address
9056 Pinto Canyon WayRoseville, CA 95747-7108
Phone 251-434-8000
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