Individual
GORDON D PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 W FERN AVE, REDLANDS, CA 92373-5916
(909) 793-3311
(909) 793-2916
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 793-3311
(909) 793-2916
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G54853
CA
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
G58853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G548530
—
CA
Enumeration date
06/06/2006
Last updated
11/26/2013
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