Organization
SOCAL CENTER FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFREY PHILLIPS M.D. (PRESIDENT)
(714) 453-0688
Entity
Organization
Contact information
Practice address
1110 E CHAPMAN AVE, SUITE 204, ORANGE, CA 92866-2139
(714) 453-0688
(714) 453-0691
Mailing address
1110 E CHAPMAN AVE, SUITE 204, ORANGE, CA 92866-2139
(714) 453-0688
(714) 453-0691
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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