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Contact Information

PHILIP T ETCHELLS, OD
13692 APPLE VALLEY RD
# 170
APPLE VALLEY, CA92308
 Phone: 760-961-1919
 Fax: 760-961-1907
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for PHILIP T ETCHELLS · (Male)

NPI Number 1245348465
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/28/2006
Last updated 05/02/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 5518T
  • CA Medicaid SD005181
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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