Individual
DR. CHARLES VINCENT PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3838 SAN DIMAS ST, STE B-231, BAKERSFIELD, CA 93301-2284
(661) 665-0505
(661) 665-7844
Mailing address
3838 SAN DIMAS ST, STE B-231, BAKERSFIELD, CA 93301-2284
(661) 665-0505
(661) 665-7844
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
Enumeration date
06/22/2005
Last updated
02/25/2015
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