Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G320830 | CA |
NPI | 1003956350 |
---|---|
Provider Name | Dr. Dennis S Phillips |
First Address | Laguna Hills, CA 92653-4342 |
Second Address | Laguna Hills, CA 92653-4342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |