Healthcare Provider Details

I. General information

NPI: 1518300151
Provider Name (Legal Business Name): MARC ERROL PHILLPOTTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2013
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHLAND ARTHRITIS AND OSTEOPOROSIS MEDICAL CENTER 31515 RANCHO PUEBLO RD. #203
TEMECULA CA
92592
US

IV. Provider business mailing address

21832 CACTUS AVE.
RIVERSIDE CA
92518
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-1500
  • Fax: 855-306-0135
Mailing address:
  • Phone: 951-924-6500
  • Fax: 855-306-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA168762
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD044077
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: