MR. MICHAEL KENNETH PHILLIPS (NPI# 1790035707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790035707 |
Entity Type | Individual |
Full Name | MR. MICHAEL KENNETH PHILLIPS |
Credential | IDC |
Practice Address |
623 Pusan Dr Oceanside CA 92058-8149 |
Practice Telephone | 8479128212 |
Mailing Telephone | 8479128212 |
Enumeration Date | 2012-09-17 |
Last Update Date | 2013-05-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
1013312578 | Michael Phillips Jr. | Counselor | 11 Ward St Ste 200, Somerville, MA 02143-4214 | 2014-10-27 |
1992099600 | Michael Zachary Phillips | Emergency Medicine | 175 Cheney Ave, Harpers Ferry, WV 25425-6343 | 2011-05-31 |
1689970535 | Michael G. Phillips | Military Health Care Provider | 2621 Las Brisas St, Corpus Christi, TX 78414-5014 | 2011-02-09 |
1750437265 | Michael Phillips | Counselor | 506 Ne Thompson St, Portland, OR 97212-3843 | 2007-01-26 |
1730234709 | Michael Phillips | Specialist | 9253 Hermosa Ave, Ste C, Rancho Cucamonga, CA 91730-5854 | 2007-01-23 |
1699845974 | Michael Stuart Phillips | Internal Medicine | 545 1st Ave, Nyu Medical Center, Greenberg Hall, Room Sc-132, New York, NY 10016-6401 | 2006-11-08 |
1225124837 | Michael Phillips | Chiropractor | 34734 Vine St, Willowick, OH 44095-5120 | 2006-10-04 |
1063520294 | Michael Newton Phillips | Physical Therapist | 3451 Goodman Rd E Ste 108, Southaven, MS 38672 | 2006-08-28 |
Street Address |
623 PUSAN DR |
City | OCEANSIDE |
State | CA |
Zip Code | 92058-8149 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508463555 | Michael William Baker | Dental Hygienist | 14th St., Oceanside, CA 92058 | 2020-10-02 |
1548877004 | Juliaisa Gisselle Caldero | Dental Assistant | Bldg 13128, Oceanside, CA 92058 | 2020-09-29 |
1932715836 | Leilani Viveros | Behavior Technician | 251 Airprort Road, Oceanside, CA 92058 | 2020-09-17 |
1043835952 | Emma Caitlin Johnson | Dentist | 92055 14th St, Bldg 13128, Oceanside, CA 92058 | 2020-06-16 |
1073135836 | Roxana Ivette Rodriguez | Military Health Care Provider | 22190 Marine Dr, Oceanside, CA 92058 | 2020-05-14 |
1699307744 | Rachael Bousman | Specialist/Technologist | 13129 14th St, Area 13, Camp Pendleton, CA 92058 | 2020-02-06 |
1811528359 | Misaael Valdes | Military Health Care Provider | Building, B St, Oceanside, CA 92058 | 2020-02-03 |
1497385736 | Phong Thanh Tran | Dental Hygienist | 599 A Ave #501, Oceanside, CA 92058 | 2020-01-24 |
1245796366 | Christian Thompson | Physician Assistant | 1st Med Bn, Camp Pendleton, Oceanside, CA 92058 | 2019-02-13 |
1104308568 | Caila Martin | Behavior Technician | 293 Douglas Dr Apt. 272, Oceanside, CA 92058 | 2018-09-02 |
Find all providers in zip 92058 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316547227 | Landri Acosta | Military Health Care Provider | 5075 Tranquil Way # 102, Oceanside, CA 92057-7870 | 2020-10-29 |
1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
1073135836 | Roxana Ivette Rodriguez | Military Health Care Provider | 22190 Marine Dr, Oceanside, CA 92058 | 2020-05-14 |
1811528359 | Misaael Valdes | Military Health Care Provider | Building, B St, Oceanside, CA 92058 | 2020-02-03 |
1023504412 | Christopher Russell Peterson | Military Health Care Provider | 909 Ash Rd, Oceanside, CA 92058-8664 | 2018-07-09 |
1902399199 | Jeremy Urbanowski | Military Health Care Provider | 656 Dogwood Ct S, Oceanside, CA 92058-6655 | 2018-06-12 |
1891297438 | Adam Christopher Jones | Military Health Care Provider | 823 Ash Rd, Oceanside, CA 92058-8662 | 2018-02-28 |
1649712639 | Robert Harrison Dickey | Military Health Care Provider | 4372 Pacifica Way, Unit 1, Oceanside, CA 92056-5781 | 2016-11-08 |
1780056218 | Kyle Cramer Hewitt | Military Health Care Provider | 1005 Fandango Ct, Oceanside, CA 92058-6757 | 2015-10-23 |
1467857490 | Adam Zani | Military Health Care Provider | 316 Taegu Ct, Oceanside, CA 92058-8151 | 2014-11-04 |
Find all providers in OCEANSIDE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.