| Ronald J. Philipp, D.O. a Prof Corp | |
|
2255 N Lakewood Blvd Long Beach CA 90815-2507 | |
| (562) 498-8000 | |
| (562) 494-8880 |
| Full Name | Ronald J. Philipp, D.O. a Prof Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 2255 N Lakewood Blvd, Long Beach, California |
| Authorized Official Name and Position | Ronald J. Philipp (PHYSICIAN/OWNER) |
| Authorized Official Contact | 5624988000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald J. Philipp, D.O. a Prof Corp 2255 N Lakewood Blvd Long Beach CA 90815-2507 Ph: (562) 498-8000 | Ronald J. Philipp, D.O. a Prof Corp 2255 N Lakewood Blvd Long Beach CA 90815-2507 Ph: (562) 498-8000 |
| NPI Number | 1972792729 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 01/08/2014 |
| Medicare PECOS PAC ID | 1850352964 |
|---|---|
| Medicare Enrollment ID | O20041021001120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972792729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 20A4777 (California) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | 20A6919 (California) | Secondary |
| Provider Name | Tara Reid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982627956 PECOS PAC ID: 1850426248 Enrollment ID: I20100324000700 |
| Provider Name | Ronald J Philipp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932120771 PECOS PAC ID: 9931160041 Enrollment ID: I20101209000771 |
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