Provider Demographics
NPI:1972756807
Name:STUTZ, PHILIP A (PHILIP STUTZ, MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:STUTZ
Suffix:
Gender:M
Credentials:PHILIP STUTZ, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 TEXAS AVE
Mailing Address - Street 2:APARTMENT 309
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1601
Mailing Address - Country:US
Mailing Address - Phone:310-478-9560
Mailing Address - Fax:
Practice Address - Street 1:11701 TEXAS AVE
Practice Address - Street 2:APARTMENT 309
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1601
Practice Address - Country:US
Practice Address - Phone:310-478-9560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG348322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry