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1023090487
GLENN PHILLIPS
MISSION VIEJO, CA
NPI
1023090487
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA 10513)
Enumeration Date
2005-11-18
Last Update Date
2016-05-26
Business Address
Mr. GLENN PHILLIPS PA
23512 MADERO
MISSION VIEJO, CA 92691-2743
Phone number: 949-583-1600
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Mailing Address
Mr. GLENN PHILLIPS PA
17360 BROOKHURST ST ATTN: CREDENTIALING DEPARTMENT
FOUNTAIN VALLEY, CA 92708-3720
Phone number: 657-241-3592
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