Healthcare Provider Details

I. General information

NPI: 1184120081
Provider Name (Legal Business Name): CAROLYN T PHILLIPS M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23803 MCBEAN PKWY SUITE 202
VALENCIA CA
91355-2001
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 661-481-2400
  • Fax: 661-255-5626
Mailing address:
  • Phone: 213-394-7921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA165646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: