Provider Demographics
NPI:1528189065
Name:CARTER-PHILLIPS, PATRICIA D (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:D
Last Name:CARTER-PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 ATLANTIC AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4569
Mailing Address - Country:US
Mailing Address - Phone:562-595-5949
Mailing Address - Fax:562-490-7395
Practice Address - Street 1:3530 ATLANTIC AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4569
Practice Address - Country:US
Practice Address - Phone:562-595-5949
Practice Address - Fax:562-490-7395
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor