Active NPI
Vicky L Phillips, MD
- Family Medicine Physician
- Covina, CA
National Provider Identifier
1114016698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G47905
- Practice address
- 800 S Barranca Ave
Covina, CA 91723-3625 - Phone
- (626) 732-8250
- Fax
- (626) 858-8474
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G47905 | CA | Primary |
Addresses
Primary practice location
800 S Barranca Ave
Covina, CA 91723-3625
Mailing address
9532 Monaco Dr
Cypress, CA 90630-3578
Phone (714) 484-8965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G479050 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47905 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1114016698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9532 MONACO DR",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906303578",
"telephone_number": "714-484-8965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S BARRANCA AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917233625",
"telephone_number": "626-732-8250",
"fax_number": "626-858-8474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "VICKY",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G47905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G479050",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.