Active NPI
Tyler Jay Phillips, M.D.
- Anesthesiology Physician
- Los Angeles, CA
National Provider Identifier
1154655181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A101305
- Practice address
- 6801 Park Ter
#300
Los Angeles, CA 90045-1543 - Phone
- (310) 665-7150
- Fax
- (310) 665-7171
- NPI assigned
- Sep 23, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A101305 | CA | Primary |
Addresses
Primary practice location
6801 Park Ter
#300
Los Angeles, CA 90045-1543
Mailing address
PO Box 4148
Torrance, CA 90510-4148
Phone (310) 792-3914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A101305 | Other | CA | STATE LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A101305 | CA | MD | Anesthesiology Physician |
| 101305 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253664000000",
"number": "1154655181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4148",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905104148",
"telephone_number": "310-792-3914",
"fax_number": "310-792-3802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 PARK TER",
"address_2": "#300",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900451543",
"telephone_number": "310-665-7150",
"fax_number": "310-665-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TYLER",
"middle_name": "JAY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-23",
"last_updated": "2009-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A101305",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "A101305",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.