Organization
C. VINCENT PHILLIPS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES VINCENT PHILLIPS M.D. (OWNER)
(661) 665-0505
Entity
Organization
Contact information
Practice address
3838 SAN DIMAS ST, SUITE B-231, BAKERSFIELD, CA 93301-2284
(661) 665-0505
Mailing address
3838 SAN DIMAS ST, SUITE B-231, BAKERSFIELD, CA 93301-2284
(661) 665-0505
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C37044
CA
2086S0129X
Vascular Surgery Physician
C37044
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020000590
MEDICARE RAILROAD
CA
05
—
GR0062760
—
CA
01
—
ZZZ43503Z
MEDICARE
CA
Enumeration date
01/15/2008
Last updated
02/26/2015
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