| Derek Truong Phan Md Inc | |
|
9191 Bolsa Ave Suite 205 Westminster CA 92683-5564 | |
| (714) 891-7035 | |
| (714) 897-8304 |
| Full Name | Derek Truong Phan Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9191 Bolsa Ave, Westminster, California |
| Authorized Official Name and Position | Derek Phan (OWNER) |
| Authorized Official Contact | 7143831661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Derek Truong Phan Md Inc 9191 Bolsa Ave Suite 205 Westminster CA 92683-5564 Ph: (714) 891-7035 | Derek Truong Phan Md Inc 9191 Bolsa Ave Suite 205 Westminster CA 92683-5564 Ph: (714) 891-7035 |
| NPI Number | 1598091837 |
|---|---|
| Provider Enumeration Date | 10/21/2009 |
| Last Update Date | 10/21/2009 |
| Medicare PECOS PAC ID | 8921142878 |
|---|---|
| Medicare Enrollment ID | O20100216000898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598091837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A99908 (California) | Primary |
| Provider Name | Derek Truong Phan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073729588 PECOS PAC ID: 1951451418 Enrollment ID: I20090604000347 |
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