Provider Information for 1518159649
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Dr. PHILLIP FOKAS
Sex: Male
NPI: 1518159649
Last Updated: 2018-04-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1518159649 | ||||||||
| Enumeration Date | 2007-08-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 13514 MESA CREST DR YUCAIPA, CA 92399-5818 United States Phone: 909-660-3234 | Fax: | ||||||||
| Primary Practice Address | 1710 BARTON RD REDLANDS, CA 92373-5304 United States Phone: 909-558-9200 | Fax: | ||||||||
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