Individual provider Active NPI

Philip L. Meyers, MD

  • Pediatrics Physician
  • Agoura Hills, CA
National Provider Identifier
1811051691
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G52107 Issued in CA
Practice address
29525 Canwood St Ste 250
Agoura Hills, CA 91301-4231
Phone
(818) 735-5555
Fax
(818) 996-4712
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-7917 HI
Pediatrics Physician 208000000X G52107 CA Primary

Addresses

Primary practice location

29525 Canwood St Ste 250
Agoura Hills, CA 91301-4231

Mailing address

24422 Avenida de la Carlota Ste 300
Laguna Hills, CA 92653-3628
Phone (949) 599-2434

Other practice location 1

18370 Burbank Blvd Ste 307
Tarzana, CA 91356-2850
Phone (818) 996-6000

Other identifiers 2

IdentifierTypeStateIssuer
0000001164OtherHIHMSA BILLING NUMBER
002221-01MedicaidHI

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

LicenseStateTypeSpecialty
G52107CAMDPediatrics Physician
MD-7917HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Kids, a Professional Medical Corporation Pediatrics PastSince Mar 6, 2022 Accepting new patients
Childrens Clinic, P.a. Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1811051691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24422 AVENIDA DE LA CARLOTA STE 300",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533628",
            "telephone_number": "949-599-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST STE 250",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014231",
            "telephone_number": "818-735-5555",
            "fax_number": "818-996-4712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18370 Burbank Blvd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913562850",
            "country_code": "US",
            "telephone_number": "818-996-6000",
            "fax_number": "818-996-4712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "PHILIP",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-7917",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G52107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000001164",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002221-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.