Provider Demographics
NPI:1477912541
Name:HITCHCOCK, PHILIP STANLEY III
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:STANLEY
Last Name:HITCHCOCK
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 APPALOOSA DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6505
Mailing Address - Country:US
Mailing Address - Phone:925-360-7267
Mailing Address - Fax:
Practice Address - Street 1:160 ALAMO PLZ
Practice Address - Street 2:UNIT 163
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-4001
Practice Address - Country:US
Practice Address - Phone:925-360-7267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies