Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57013586 | OH |
N | 111NI0900X | Internist | 57013586 | OH |
N | 207RC0200X | Critical Care Medicine | A112464 | CA |
Y | 207RP1001X | Pulmonary Disease | A112464 | CA |
NPI | 1063601045 |
---|---|
Provider Name | Rajiv Philip |
First Address | Pasadena, CA 91106-1451 |
Second Address | Pasadena, CA 91106-1451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 13/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A112464 | (05) | CA |
W481 | MEDICARE GROUP (01) | CA |