Individual
RONALD J. PHILIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2255 N LAKEWOOD BLVD, LONG BEACH, CA 90815-2507
(562) 498-8000
(562) 494-8880
Mailing address
2255 N LAKEWOOD BLVD, LONG BEACH, CA 90815-2507
(562) 498-8000
(562) 494-8880
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
20A4777
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX47770
—
CA
01
—
1932120771
MEDICARE INDIVIDUAL NPI
CA
01
—
1972792729
MEDICARE GROUP NPI
CA
05
—
GR0105170
—
CA
Enumeration date
07/21/2006
Last updated
01/29/2010
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