Provider Demographics
NPI:1457707929
Name:PHILLIPS, IRVING JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:IRVING
Middle Name:JAMES
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 JOHN JONES RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-9701
Mailing Address - Country:US
Mailing Address - Phone:530-758-2060
Mailing Address - Fax:530-758-8490
Practice Address - Street 1:2051 JOHN JONES RD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-9701
Practice Address - Country:US
Practice Address - Phone:530-758-2060
Practice Address - Fax:530-758-8490
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA167811208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics