Healthcare Provider Details

I. General information

NPI: 1598742264
Provider Name (Legal Business Name): THOMAS J PHILLIPS MD A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12522 E LAMBERT RD STE A
WHITTER CA
90606-2758
US

IV. Provider business mailing address

PO BOX 5608
WHITTIER CA
90607-5608
US

V. Phone/Fax

Practice location:
  • Phone: 562-693-8253
  • Fax: 562-693-0155
Mailing address:
  • Phone: 562-693-8253
  • Fax: 562-693-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS J PHILLIPS
Title or Position: OWNER
Credential: MD
Phone: 562-693-8253