Provider Demographics
NPI:1578523692
Name:MADRID, PHILIP E (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:E
Last Name:MADRID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2501 E CHAPMAN AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3223
Mailing Address - Country:US
Mailing Address - Phone:714-628-3340
Mailing Address - Fax:714-633-7349
Practice Address - Street 1:2501 E CHAPMAN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3223
Practice Address - Country:US
Practice Address - Phone:714-628-3340
Practice Address - Fax:714-633-7349
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45165207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine