PHILLIP WILLIE TAN POLIDO (M.D) – Surgery Physician, NPI 1245320001

PHILLIP WILLIE TAN POLIDO (M.D) is a healthcare provider. based in Antioch, California. specializing in Surgery Physician. They hold the professional credentials M.D. They hold a License No. A32794 (CA). The NPI Number for PHILLIP WILLIE TAN POLIDO (M.D) is 1245320001

Main info

Male
49 Years Of Experience
Accepts Medicare Assignment
Name
PHILLIP WILLIE TAN POLIDO (M.D)
NPI
1245320001
Phone
(925) 757-0800
Address
2350 COUNTRY HILLS DR STE A
Enumeration Date
13 October 2006
Last Update Date
12 February 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Secondary Phone
9257570800
Graduation Year
1977 (49 years ago)
PAC ID
8921177478
Group Practice PAC ID
9032111281
Professional Enrollment ID
I20080523000150
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for PHILLIP WILLIE TAN POLIDO (M.D)

  • 2350 COUNTRY HILLS DR STE A

    ANTIOCH, CA 945097436

    Phone: (925) 757-0800

    Fax: (925) 757-2160

    Type: Location

  • 2637, Shadelands Drive, Shadelands Business Park, Walnut Creek, Contra Costa County, California, 94598, United States

    WALNUT CREEK, CA 945982512

    Phone: (925) 948-8143

    Type: Mailing

  • Lone Tree Way, Antioch, Contra Costa County, California, 94509, United States

    SUITE 210

    ANTIOCH, CA 945096249

    Phone: (925) 757-0800

    Fax: (925) 757-2160

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94509)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032111281View full group profile
NameSpecialtyState
-CA
G A S T R O E N T E R O L O G YCA
General SurgeryCA
N E U R O S U R G E R YCA
-CA
O B S T E T R I C S/ G Y N E C O L O G YCA
P O D I A T R YCA
-CA
E N D O C R I N O L O G YKS
Qualified AudiologistCA

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Frequently asked questions

What number should I use to identify PHILLIP WILLIE TAN POLIDO (M.D) for billing?
Administrative and clinical systems typically use NPI 1245320001 for PHILLIP WILLIE TAN POLIDO (M.D).
Is PHILLIP WILLIE TAN POLIDO (M.D)'s NPI status active today?
Active status means PHILLIP WILLIE TAN POLIDO (M.D)'s NPI record is not deactivated in the public file.
Which specialty label fits PHILLIP WILLIE TAN POLIDO (M.D)?
NPPES ties PHILLIP WILLIE TAN POLIDO (M.D) to Surgery Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to PHILLIP WILLIE TAN POLIDO (M.D)?
PHILLIP WILLIE TAN POLIDO (M.D) is associated with Antioch, California in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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