Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 28718 | OK |
N | 207RX0202X | Medical Oncology | 35601 | TN |
Y | 207RX0202X | Medical Oncology | C157739 | CA |
NPI | 1003952151 |
---|---|
Provider Name | Dr. Tanyanika Phillips |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Lancaster, CA 93534-4079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000225087 | UNISON (01) | OH |
000000537783 | ANTHEM (01) | OH |
2770998 | (05) | OH |
421818 | WELLCARE (01) | |
751234 | BUCKEYE (01) | OH |
7794493 | AETNA (01) | OH |