Philip Paul Tristan, is a
Community Health Worker based in Fresno, California. Philip Paul Tristan is licensed to practice in * (Not Available) (license number ) and his current practice location is
4468 E Kings Canyon Rd, Fresno, California. He can be reached at his office (for appointments etc.) via phone at
(559) 600-9500.
NPI number for Philip Paul Tristan is 1588216170 and his current mailing address is 2639 N Selland Ave, Fresno, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1588216170.
Healthcare Provider's Profile
| Full Name | Philip Paul Tristan |
|---|
| Gender | Male |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 4468 E Kings Canyon Rd, Fresno, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1588216170
- Provider Enumeration Date: 07/12/2019
- Last Update Date: 01/23/2024
Medical Identifiers
Medical identifiers for Philip Paul Tristan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588216170 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (California) | Secondary |
| 101Y00000X | Counselor | 101Y00000X (* (Not Available)) | Secondary |
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Philip Paul Tristan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Philip Paul Tristan,
2639 N Selland Ave,
Fresno, CA 93722-6714
Ph: (559) 373-9583 | Philip Paul Tristan,
4468 E Kings Canyon Rd,
Fresno, CA 93702-3605
Ph: (559) 600-9500 |
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