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NPI Code Detail

MEDICARE: ALLISON PHILLIPS CNC

MEDICARE: ALLISON PHILLIPS CNC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133NN1002XNutrition Education Nutritionist

General Provider Information

NPI Number : 1427545326
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON PHILLIPS CNC
Provider Business Mailing Address
First Line : 1427 CERRITOS DR
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-2818
Country : US
Telephone Number : 949-831-3801
Fax Number : 949-831-3801
Provider Business Practice Location Address
First Line : 1427 CERRITOS DR
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-2818
Country : US
Telephone Number : 949-831-3801
Fax Number : 949-831-3801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2018
Last Update Date : 04/16/2018

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