Provider Demographics
NPI:1285713586
Name:PHILLEY, FRANCES ANNE (MD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:ANNE
Last Name:PHILLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-1308
Mailing Address - Country:US
Mailing Address - Phone:619-445-8729
Mailing Address - Fax:619-956-2934
Practice Address - Street 1:9065 EDGEMOOR DR
Practice Address - Street 2:EDGEMOOR HOSPITAL
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3037
Practice Address - Country:US
Practice Address - Phone:619-956-2853
Practice Address - Fax:619-956-2934
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78283207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF83565Medicare UPIN