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General NPI Number Information
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NPI Number | 1083996516
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Entity Type | Organization
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Legal Business Name | DR LILY PHILLIPS MD MEDICAL GROUP
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Dates
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Enumeration Date | 09/11/2011
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Last Update Date | 09/11/2011
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Provider Practice Location Address
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Address Line | 24910 LAS BRISAS RD SUITE 106
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City | MURRIETA
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State | CA
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Zip | 92562-4010
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Country | US
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Telephone | 951-667-7780
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Fax | 888-604-2214
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Provider Business Mailing Address
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Address Line | 24910 LAS BRISAS RD SUITE 106
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City | MURRIETA
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State | CA
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Zip | 92562-4010
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Country | US
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Telephone | 951-667-7780
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Fax | 888-604-2214
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Authorized Official
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Title or Position | CEO
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Name | DR. LILY YUNG PHILLIPS
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Credential | M.D.
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Telephone | 951-667-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A66038
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License Number State | CA
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