Organization Name: | TUAN VAN PHAN MD. INC. |
NPI Number: | 1134379183 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TUAN VAN PHAN (CEO) |
Mailing Address: | 2641 Senter Rd. San Jose |
State: | CA US |
Postal Code: | 951111122 |
Phone Number: | 4089240786 |
Fax Number: | 4089240788 |
NPI Enumeration Date: | 09/26/2008 |
NPI Last Update Date: | 09/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A51069 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |