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NPI Code Detail

MEDICARE: MR. GASTON PHILLIPS

MEDICARE:  MR. GASTON  PHILLIPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2253Z00000XIn Home Supportive Care Agency
3251J00000XNursing Care Agency
4347C00000XPrivate Vehicle
5372600000XAdult Companion
6374U00000XHome Health Aide
7376K00000XNurse's Aide

General Provider Information

NPI Number : 1316188402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GASTON PHILLIPS
Provider Business Mailing Address
First Line : 1 WORLD TRADE CTR
Second Line : SUITE 800
City : LONG BEACH
State : CA
Zip : 90831-0002
Country : US
Telephone Number : 866-508-2236
Fax Number : 619-330-2153
Provider Business Practice Location Address
First Line : 11801 PIERCE ST
Second Line : SUITE 200
City : RIVERSIDE
State : CA
Zip : 92505-4400
Country : US
Telephone Number : 877-844-4421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 03/19/2009

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Directions to “ MR. GASTON PHILLIPS ” Practice Location

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