Provider Demographics
NPI:1336526888
Name:DESOUZA, PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:DESOUZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3 SCRIPPS DRIVE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-927-0800
Mailing Address - Fax:613-707-0213
Practice Address - Street 1:3 SCRIPPS DRIVE
Practice Address - Street 2:SUITE #200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-927-0800
Practice Address - Fax:613-707-0213
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2024-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT208350207R00000X
NC216024207W00000X
CAA160606207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology