Provider Demographics
NPI:1922053305
Name:SCHEEL, PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:SCHEEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WEST COAST RD.
Mailing Address - Street 2:PO BOX 769
Mailing Address - City:REDWAY
Mailing Address - State:CA
Mailing Address - Zip Code:95560-0769
Mailing Address - Country:US
Mailing Address - Phone:707-923-2783
Mailing Address - Fax:707-923-2543
Practice Address - Street 1:101 WEST COAST RD.
Practice Address - Street 2:
Practice Address - City:REDWAY
Practice Address - State:CA
Practice Address - Zip Code:95560-0769
Practice Address - Country:US
Practice Address - Phone:707-923-2783
Practice Address - Fax:707-923-2543
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A786230Medicaid
CA00A786232Medicare PIN
CA00A786236Medicare PIN
CA00A786237Medicare PIN
CAWA78623GMedicare PIN
CAWA78623AMedicare PIN
CAWA78623DMedicare PIN
CA00A786234Medicare PIN
CAWA78623CMedicare PIN
CAH76681Medicare UPIN
CA00A786230Medicaid
CAWA78623BMedicare PIN
CAWA78623EMedicare PIN
CA00A786235Medicare PIN
CA00A786233Medicare PIN