Tracy T. Phillips, MD, Medical Corporation

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A84062 Issued in CA

Legal business name

TRACY T. PHILLIPS, MD, MEDICAL CORPORATION

Practice address

2089 Vale Road
Suite 10
San Pablo, CA 94806

Phone

(510) 234-4235

NPI assigned

Oct 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy T Phillips, MD

Title

President

Phone

(510) 435-3311

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1316031818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 VALE ROAD",
            "address_2": "SUITE 10",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806",
            "telephone_number": "510-234-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 VALE ROAD",
            "address_2": "SUITE 10",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806",
            "telephone_number": "510-234-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY T. PHILLIPS, MD, MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-435-3311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A84062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.