Provider Demographics
NPI:1710082235
Name:PHILLIPS, ROBERT (PA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24910 LAS BRISAS RD
Mailing Address - Street 2:105
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-231-1385
Mailing Address - Fax:866-345-3272
Practice Address - Street 1:24910 LAS BRISAS RD
Practice Address - Street 2:105
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-231-1385
Practice Address - Fax:866-345-3272
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA14755363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant