Provider Demographics
NPI:1124595822
Name:NORTH VALLEY NEUROLOGIC ASSOCIATES
Entity Type:Organization
Organization Name:NORTH VALLEY NEUROLOGIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-751-9604
Mailing Address - Street 1:367 DEL NORTE #4
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4116
Mailing Address - Country:US
Mailing Address - Phone:530-751-9604
Mailing Address - Fax:530-751-9530
Practice Address - Street 1:367 DEL NORTE #4
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4116
Practice Address - Country:US
Practice Address - Phone:530-751-9604
Practice Address - Fax:530-751-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty