Provider Demographics
NPI:1598742264
Name:THOMAS J PHILLIPS MD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:THOMAS J PHILLIPS MD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-693-8253
Mailing Address - Street 1:PO BOX 5608
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90607-5608
Mailing Address - Country:US
Mailing Address - Phone:562-693-8253
Mailing Address - Fax:562-693-0155
Practice Address - Street 1:12522 E LAMBERT RD
Practice Address - Street 2:STE A
Practice Address - City:WHITTER
Practice Address - State:CA
Practice Address - Zip Code:90606-2758
Practice Address - Country:US
Practice Address - Phone:562-693-8253
Practice Address - Fax:562-693-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty