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General NPI Number Information
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NPI Number | 1811913924
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Entity Type | Individual
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Provider Name | PHILIP J CLEMENTS MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 200 MEDICAL PLAZA #214,365,530,420,120
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-825-0631
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 200
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City | LOS ANGELES
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State | CA
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Zip | 90045-5632
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Country | US
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Telephone | 310-301-8707
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Fax | 310-301-8751
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | C30414
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License Number State | CA
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