Provider Information for 1669420642
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Mr. PHILIP BEITEL M.A., M.S., MFT
Sex: Male
NPI: 1669420642
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669420642 | ||||||||
| Enumeration Date | 2006-05-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1010 SIR FRANCIS DRAKE BLVD SUITE 2E KENTFIELD, CA 94904-1423 United States Phone: 415-479-6064 | Fax:206-203-4394 | ||||||||
| Primary Practice Address | 1010 SIR FRANCIS DRAKE BLVD SUITE 2E KENTFIELD, CA 94904-1423 United States Phone: 415-479-6064 | Fax:206-203-4394 | ||||||||
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