Provider Demographics
NPI:1265423610
Name:EGGLESTON PHILAPIL, ROCHELLE ANA (MD)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:ANA
Last Name:EGGLESTON PHILAPIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:ANA
Other - Last Name:EGGLESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4301 NORTHSTAR WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9262
Mailing Address - Country:US
Mailing Address - Phone:209-342-2300
Mailing Address - Fax:209-524-4240
Practice Address - Street 1:20103 LAKE CHABOT RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5341
Practice Address - Country:US
Practice Address - Phone:209-342-2300
Practice Address - Fax:209-524-4240
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61510207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A615100Medicaid
CA00A615100OtherBLUE SHIELD
CA00A615100Medicare PIN
CA00A615100Medicaid
CA00A669801Medicare PIN