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NPI Code Detail

MEDICARE: PHILLIP T GU MD

MEDICARE: PHILLIP T GU MD
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
1207R00000XInternal Medicine Physician148851CA
2390200000XStudent in an Organized Health Care Education/Training Program
3207RG0100XGastroenterology PhysicianA148851CA

General Provider Information

NPI Number : 1447647268
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP T GU MD
Provider Business Mailing Address
First Line : 4140 W 190TH ST
Second Line :
City : TORRANCE
State : CA
Zip : 90504-5513
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8700 BEVERLY BLVD STE 1128
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90048-1804
Country : US
Telephone Number : 310-423-4100
Fax Number : 310-423-0416
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2015
Last Update Date : 08/02/2022

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