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Individual

DR. PHILIP ORMOND MERRITT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1505 WILSON TER, SUITE 200, GLENDALE, CA 91206-4071
(818) 246-8974
(818) 246-7673
Mailing address
1357 SUGAR LOAF DR, LA CANADA, CA 91011-3919
(818) 790-7066

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
G46741
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G467410
CA
01
G46741
MEDICAL BOARD
CA
01
RHD 130967
X-RAY SUPERVISOR & OPERAT
CA
Enumeration date
11/16/2005
Last updated
03/07/2023
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