Provider Demographics
NPI:1932425303
Name:ANDRES, PHILIP ADRIAN (NP)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ADRIAN
Last Name:ANDRES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SULLIVAN AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:415-680-4135
Mailing Address - Fax:
Practice Address - Street 1:1900 SULLIVAN AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:415-680-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA746599163W00000X
CA22938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse