Phillip Dickinson, M.D., a Professional Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A86720 Issued in CA

Legal business name

PHILLIP DICKINSON, M.D., A PROFESSIONAL CORPORATION

Practice address

8554 La Mesa Blvd
La Mesa, CA 91941-3958

Phone

(619) 464-4469

Fax

(619) 713-0479

NPI assigned

Sep 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Phillip W. Dickinson, M.D.NPI 1386737773

Title

President and Ceo

Phone

(619) 464-4469

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Dickinson, M.D.

  • Family Medicine Physician
  • La Mesa, CA
  • NPI 1386737773
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292112000000",
    "number": "1467600270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2213",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919432213",
            "telephone_number": "619-464-4469",
            "fax_number": "619-713-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8554 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413958",
            "telephone_number": "619-464-4469",
            "fax_number": "619-713-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP DICKINSON, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2010-12-12",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "619-464-4469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matt T Pham, O.D.
• Quynh Vo Bao Pham, DDS
• Thuy-Linh Pham
• Thanhtruc Hoang Phan, FNP-C
• Philip D Szold MD Inc
• Jarrad Marshall Phillips, ATC
• Julie Christine Phillips, M.D.
• Justine Phillips, ATC
• Lanard Phillips Sr.
• Kelly Phommahaxay, M.D.

• Surgery Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.