Provider Demographics
NPI:1508273368
Name:PHILIP B. SANFILIPPO II, DPM
Entity Type:Organization
Organization Name:PHILIP B. SANFILIPPO II, DPM
Other - Org Name:PHILIP B. SANFILIPPO II, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:650-245-2235
Mailing Address - Street 1:2555 OCEAN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1645
Mailing Address - Country:US
Mailing Address - Phone:650-245-2235
Mailing Address - Fax:949-862-7639
Practice Address - Street 1:2555 OCEAN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1645
Practice Address - Country:US
Practice Address - Phone:650-245-2235
Practice Address - Fax:949-862-7639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3614213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty