Provider Demographics
NPI:1245441989
Name:KAMINS, PHILIP
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:KAMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 ALMA REAL DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3731
Mailing Address - Country:US
Mailing Address - Phone:310-459-3088
Mailing Address - Fax:310-454-9555
Practice Address - Street 1:881 ALMA REAL DR
Practice Address - Street 2:SUITE 315
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3731
Practice Address - Country:US
Practice Address - Phone:310-459-3088
Practice Address - Fax:310-454-9555
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA359151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice