Basic Information
| Provider Information | |||||||||
| NPI: | 1053354910 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PHILLIPOSIAN | ||||||||
| FirstName: | CAREY | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 SUTTER ST RM 934 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941083997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153622901 | ||||||||
| FaxNumber: | 4153622429 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 SUTTER ST RM 934 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941083997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153622901 | ||||||||
| FaxNumber: | 4153622429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AU1869 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | AU1869 | CA | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
ID Information
| ID | Type | State | Issuer | Description | 00AU18690 | 05 | CA | MEDICAID |