Provider Demographics
NPI:1487716080
Name:PHILLIPS, CINDY CHU (MPT, OCS)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:CHU
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2813
Mailing Address - Country:US
Mailing Address - Phone:818-637-2127
Mailing Address - Fax:818-637-2126
Practice Address - Street 1:500 W GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202
Practice Address - Country:US
Practice Address - Phone:818-637-2127
Practice Address - Fax:818-637-2126
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic