Doctor Name: | DR. PHILLIP DE EVANS BRETZ |
NPI Number: | 1740211838 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A32596 |
Business Practice Address: | 35280 Bob Hope Dr Suite 103 Rancho Mirage, CA - 922701753 |
Business Phone Number: | 7603248323 |
Business Fax Number: | 7603248779 |
Mailing Address: | Po Box 600534, SAN DIEGO |
State: | CA |
Postal Code: | 921600534 |
Phone Number: | 8007756029 |
Fax Number: | 6192200905 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A32596 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |