Provider Demographics
NPI:1962408070
Name:FRANKEL, PHILLIP S (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:S
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E HARDY ST
Mailing Address - Street 2:STE 200
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4057
Mailing Address - Country:US
Mailing Address - Phone:310-672-3900
Mailing Address - Fax:310-671-8438
Practice Address - Street 1:501 E HARDY ST
Practice Address - Street 2:STE 200
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4057
Practice Address - Country:US
Practice Address - Phone:310-672-3900
Practice Address - Fax:310-671-8438
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33330174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G333300Medicaid
CAG33330OtherMEDICAL LICENSE
CA00G333300Medicaid
CAG33330Medicare ID - Type UnspecifiedMEDICARE