Individual
DR. JUANA CONSTANTINA PHILLIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
130 W ROUTE 66, SUITE #220, GLENDORA, CA 91740-6249
(626) 914-5803
Mailing address
130 W ROUTE 66, SUITE #220, GLENDORA, CA 91740-6249
(626) 914-5803
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A33955
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOA339550
—
CA
Enumeration date
02/01/2007
Last updated
06/10/2008
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