Provider Demographics
NPI:1932937257
Name:PHLEX65 INC.
Entity type:Organization
Organization Name:PHLEX65 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:LIKUBIAU
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:GERONTOLOGY SPECIALI
Authorized Official - Phone:408-828-1511
Mailing Address - Street 1:PO BOX 26593
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95159-6593
Mailing Address - Country:US
Mailing Address - Phone:408-828-1511
Mailing Address - Fax:
Practice Address - Street 1:1089 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-3155
Practice Address - Country:US
Practice Address - Phone:408-828-1511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty