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NPI Code Detail

MEDICARE: DR. ALLAN BURTON PHILLIPS M.D.

MEDICARE:  DR. ALLAN BURTON PHILLIPS  M.D.
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
12084P0800XPsychiatry PhysicianG38170CA

General Provider Information

NPI Number : 1912088204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLAN BURTON PHILLIPS M.D.
Provider Business Mailing Address
First Line : 14724 VENTURA BLVD STE 1000
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-3510
Country : US
Telephone Number : 818-784-7105
Fax Number : 818-784-2663
Provider Business Practice Location Address
First Line : 14724 VENTURA BLVD STE 1000
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-3510
Country : US
Telephone Number : 818-943-5514
Fax Number : 818-784-2663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 08/31/2022

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