Provider Demographics
NPI:1184120081
Name:PHILLIPS, CAROLYN T (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:T
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9602
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:213-394-7921
Mailing Address - Fax:
Practice Address - Street 1:23803 MCBEAN PKWY SUITE 202
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-481-2400
Practice Address - Fax:661-255-5626
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA165646207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology