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NPI Code Detail

MEDICARE: CATHERINE MCCLAIN PHILLIPS PA C

MEDICARE:   CATHERINE MCCLAIN PHILLIPS  PA C
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
1363A00000XPhysician AssistantPA14037CA

General Provider Information

NPI Number : 1336132422
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE MCCLAIN PHILLIPS PA C
Provider Business Mailing Address
First Line : 30125 AGOURA RD
Second Line : STE 200
City : AGOURA HILLS
State : CA
Zip : 91301-4337
Country : US
Telephone Number : 818-707-9603
Fax Number : 818-707-1276
Provider Business Practice Location Address
First Line : 3605 ALAMO ST
Second Line : STE 100
City : SIMI VALLEY
State : CA
Zip : 93063-2186
Country : US
Telephone Number : 805-522-6577
Fax Number : 805-522-7030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 04/25/2011

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Directions to “ CATHERINE MCCLAIN PHILLIPS PA C” Practice Location

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