Active NPI
Geoffrey B. Phillips, M.D.
- Psychiatry Physician
- Santa Ana, CA
National Provider Identifier
1396745501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A81687
- Practice address
- 601 Parkcenter Dr
Suite 206
Santa Ana, CA 92705-3522 - Phone
- (714) 453-0688
- Fax
- (714) 453-0691
- NPI assigned
- Jul 29, 2005
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A81687 | CA | Primary |
Addresses
Primary practice location
601 Parkcenter Dr
Suite 206
Santa Ana, CA 92705-3522
Mailing address
601 Parkcenter Dr
Suite 206
Santa Ana, CA 92705-3522
Phone (714) 453-0688
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 548946 | Other | CA | VALUE OPTIONS PIN |
| 00A816710 | Medicaid | CA | |
| 365136 | Other | CA | MGED HEALTH NETWORK PIN |
| 00A816710 | Other | CA | BLUE SHIELD - UBH PIN |
| LICENSE # A81687 | Other | CA | MEDICAL LICENSE # |
| 7871001 | Other | AETNA BH PIN |
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 |
|---|---|---|---|
| A81687 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sameh Elsanadi MD,Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- Irvine, CA
- NPI 1396881207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1396745501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 PARKCENTER DR",
"address_2": "SUITE 206",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053522",
"telephone_number": "714-453-0688",
"fax_number": "714-453-0691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 PARKCENTER DR",
"address_2": "SUITE 206",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053522",
"telephone_number": "714-453-0688",
"fax_number": "714-453-0691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "GEOFFREY",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A81687",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PIN",
"identifier": "548946",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A816710",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MGED HEALTH NETWORK PIN",
"identifier": "365136",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD - UBH PIN",
"identifier": "00A816710",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE #",
"identifier": "LICENSE # A81687",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BH PIN",
"identifier": "7871001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.