Organization Name: | PATRICK PHAN, M.D., P.S. |
NPI Number: | 1841420593 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICK T. PHAN (PRESIDENT) |
Mailing Address: | 2902 112th Ave Se Bellevue |
State: | WA US |
Postal Code: | 980047528 |
Phone Number: | 2067254322 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2009 |
NPI Last Update Date: | 07/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD00026346 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |