Provider Demographics
NPI:1578629366
Name:ANDREW F. PHILLIPS MD, INC.
Entity Type:Organization
Organization Name:ANDREW F. PHILLIPS MD, INC.
Other - Org Name:PHILLIPS EYE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:FISHER
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-446-1600
Mailing Address - Street 1:301 W HUNTINGTON DR
Mailing Address - Street 2:SUITE 605
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3462
Mailing Address - Country:US
Mailing Address - Phone:626-446-1600
Mailing Address - Fax:626-446-9986
Practice Address - Street 1:301 W HUNTINGTON DR
Practice Address - Street 2:SUITE 605
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3462
Practice Address - Country:US
Practice Address - Phone:626-446-1600
Practice Address - Fax:626-446-9986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78557152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18397Medicare ID - Type Unspecified
CAY26956Medicare UPIN