Individual
DR. PHILLIP STEPHEN BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1127 WILSHIRE BLVD, SUITE 1010, LOS ANGELES, CA 90017-4001
(213) 977-1047
(213) 977-9160
Mailing address
1127 WILSHIRE BLVD, SUITE 1010, LOS ANGELES, CA 90017-4001
(213) 977-1047
(213) 977-9160
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
G62795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G627950
—
CA
Enumeration date
10/20/2006
Last updated
04/02/2014
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