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General NPI Number Information
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NPI Number | 1114016698
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Entity Type | Individual
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Provider Name | VICKY L PHILLIPS MD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 800 S BARRANCA AVE
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City | COVINA
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State | CA
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Zip | 91723-3625
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Country | US
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Telephone | 626-732-8250
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Fax | 626-858-8474
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Provider Business Mailing Address
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Address Line | 9532 MONACO DR
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City | CYPRESS
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State | CA
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Zip | 90630-3578
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Country | US
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Telephone | 714-484-8965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G47905
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License Number State | CA
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