Healthcare Provider Details

I. General information

NPI: 1457203473
Provider Name (Legal Business Name): LORNIE PHILLIPS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19845 LAKE CHABOT RD STE 200
CASTRO VALLEY CA
94546-4055
US

IV. Provider business mailing address

19845 LAKE CHABOT RD STE 200
CASTRO VALLEY CA
94546-4055
US

V. Phone/Fax

Practice location:
  • Phone: 510-538-5500
  • Fax:
Mailing address:
  • Phone: 510-538-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LORNIE PHILLIPS II
Title or Position: OWNER
Credential: MD
Phone: 510-538-5500