Provider Demographics
NPI:1528405503
Name:PHILP, JOSHUA SETH
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SETH
Last Name:PHILP
Suffix:
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 1:1695 MERRILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-5919
Mailing Address - Country:US
Mailing Address - Phone:585-802-2098
Mailing Address - Fax:
Practice Address - Street 1:1695 MERRILL DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-5919
Practice Address - Country:US
Practice Address - Phone:585-802-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02231981J242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist