Provider Demographics
NPI:1134494271
Name:RODGER PHILLIPS, D.C. APC
Entity Type:Organization
Organization Name:RODGER PHILLIPS, D.C. APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:R
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-253-1200
Mailing Address - Street 1:21700 GOLDEN TRIANGLE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2616
Mailing Address - Country:US
Mailing Address - Phone:661-253-1200
Mailing Address - Fax:661-253-1276
Practice Address - Street 1:21700 GOLDEN TRIANGLE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2616
Practice Address - Country:US
Practice Address - Phone:661-253-1200
Practice Address - Fax:661-253-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669594370OtherNPI
1669594370OtherNPI