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Individual

GEOFFREY B. PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 PARKCENTER DR, SUITE 206, SANTA ANA, CA 92705-3522
(714) 453-0688
(714) 453-0691
Mailing address
601 PARKCENTER DR, SUITE 206, SANTA ANA, CA 92705-3522
(714) 453-0688
(714) 453-0691

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A81687
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A816710
BLUE SHIELD - UBH PIN
CA
05
00A816710
CA
01
365136
MGED HEALTH NETWORK PIN
CA
01
548946
VALUE OPTIONS PIN
CA
01
7871001
AETNA BH PIN
01
LICENSE # A81687
MEDICAL LICENSE #
CA
Enumeration date
07/29/2005
Last updated
06/18/2014
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