Doctor Name: | TUAN ANH PHAN |
NPI Number: | 1477988004 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A36152 |
Business Practice Address: | 1405 N Bristol St Santa Ana, CA - 927063303 |
Business Phone Number: | 7145427609 |
Business Fax Number: | 7145650749 |
Mailing Address: | 1405 N Bristol St, SANTA ANA |
State: | CA |
Postal Code: | 927063303 |
Phone Number: | 7145427609 |
Fax Number: | 7145650749 |
NPI Enumeration Date: | 09/13/2013 |
NPI Last Update Date: | 09/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A36152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |