PHILLIP CONNOLLY (NPI# 1114312196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114312196 |
| Entity Type | Individual |
| Full Name | PHILLIP CONNOLLY |
| Practice Address |
409 N Pacific Coast Hwy Ste 166 Redondo Beach CA 90277-2870 |
| Practice Telephone | 8056603510 |
| Practice Fax Number | 8662253208 |
| Mailing Telephone | 8056603510 |
| Mailing Fax Number | 8662253208 |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2015-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
409 N PACIFIC COAST HWY STE 166 |
| City | REDONDO BEACH |
| State | CA |
| Zip Code | 90277-2870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699169235 | Surgical Evolution, Inc. | Durable Medical Equipment & Medical Supplies | 409 N Pacific Coast Hwy Ste 166, Redondo Beach, CA 90277-2870 | 2015-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215103 | Robert John Coffman | Psychologist | 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 | 2020-02-04 |
| 1952949786 | Anne E Pitts | Dietitian, Registered | 360 The Village Drive Unit 207, Redondo Beach, CA 90277 | 2019-12-11 |
| 1558916841 | Dana Bryon Staub | Social Worker | 205 Ave. I, Suite 17, Redondo Beach, CA 90277 | 2019-08-05 |
| 1376033860 | Lisa Ann Graziano | Marriage & Family Therapist | 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 | 2018-05-10 |
| 1275981326 | Carla Marie Vasquez | Marriage & Family Therapist | 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2016-05-31 |
| 1154793628 | Marianne M. Cuttic, Dpm, Inc | Podiatrist | 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 | 2015-10-23 |
| 1841682994 | Mary Schopfel | Counselor | 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2015-02-26 |
| 1700287141 | Rose Ross | Marriage & Family Therapist | 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 | 2014-09-04 |
| 1912307661 | Gale Hazeltine | Physical Therapist | 409 N PCh Hwy # 308, Redondo Beach, CA 90277 | 2014-08-31 |
| 1194135889 | Physical Therapy Concierge Service Inc | Clinic/Center | 704 N. Irena, B, Redondo Beach, CA 90277 | 2014-05-02 |
| Find all providers in zip 90277 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215479712 | Octavio Calderon | Specialist/Technologist, Other | 409 N Pacific Coast Hwy, Redondo Beach, CA 90277-2870 | 2016-11-15 |
| 1629510128 | Tim Gonzalez | Specialist/Technologist, Other | 409 N Pacific Coast Hwy, Redondo Beach, CA 90277-2870 | 2016-11-15 |
| 1740664663 | Comprehensive Surgical Solutions, LLC | Specialist/Technologist, Other | 409 N Pacific Coast Hwy, Suite 166, Redondo Beach, CA 90277-2870 | 2015-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996296 | Kelly Olivia Brand | Specialist/Technologist, Other | 11044 Tennessee Ave, Los Angeles, CA 90064-1966 | 2020-06-09 |
| 1417576901 | Alpha Neuro-monitoring, LLC | Specialist/Technologist, Other | 751 E Blithedale Ave # 369, Mill Valley, CA 94941-1515 | 2020-04-14 |
| 1386276624 | Pinpoint Monitoring LLC | Specialist/Technologist, Other | 73521 Jameson Rd, Palm Desert, CA 92211-2031 | 2020-02-05 |
| 1255986329 | Hope Diagnostics Inc | Specialist/Technologist, Other | 10999 Riverside Dr 204, North Hollywood, CA 91602-2239 | 2019-08-06 |
| 1982267001 | California Diagnostic Specialists, Inc. | Specialist/Technologist, Other | 9191 Westminster Ave # 209, Garden Grove, CA 92844-2751 | 2019-04-15 |
| 1083174213 | Svetlana Almeida | Specialist/Technologist, Other | 28201 La Plumosa, Laguna Niguel, CA 92677-7049 | 2019-03-22 |
| 1629535604 | Diego Bautista | Specialist/Technologist, Other | 324 S Beverly Drive #214, Beverely Hills, CA 90212 | 2019-02-26 |
| 1184191256 | Satellite Medical LLC | Specialist/Technologist, Other | 3478 Buskirk Ave Ste 140, Pleasant Hill, CA 94523-4383 | 2018-10-26 |
| 1063994879 | Martin Phan | Specialist/Technologist, Other | 2995 Edison Dr, San Jose, CA 95133-2412 | 2018-08-29 |
| 1285123588 | Vincent Mattiello | Specialist/Technologist, Other | 13924 Marquesas Way Apt 2302, Marina Del Rey, CA 90292-6020 | 2018-05-02 |
| Find all providers with the same taxonomy | ||||
| City | REDONDO BEACH |
| Zip Code | 90277 |
Please comment or provide details below to improve the information on PHILLIP CONNOLLY.
| 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.