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General NPI Number Information
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NPI Number | 1295943884
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Entity Type | Individual
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Provider Name | ANCIL K. PHILIP MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 2251 W ROSECRANS AVE STE 21
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City | COMPTON
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State | CA
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Zip | 90222-3860
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Country | US
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Telephone | 424-529-6755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845833
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City | LOS ANGELES
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State | CA
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Zip | 90084-5833
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Country | US
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Telephone | 310-792-3914
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 54417-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A147208
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License Number State | CA
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