| Dung My Phan Md Inc | |
|
1693 Flanigan Dr Suite #100 San Jose CA 95121-1683 | |
| (408) 274-3881 | |
| (408) 274-9053 |
| Full Name | Dung My Phan Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1693 Flanigan Dr, San Jose, California |
| Authorized Official Name and Position | Dung My Phan (PRESIDENT) |
| Authorized Official Contact | 4082743881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dung My Phan Md Inc 1693 Flanigan Dr Suite #100 San Jose CA 95121-1683 Ph: (408) 274-3881 | Dung My Phan Md Inc 1693 Flanigan Dr Suite #100 San Jose CA 95121-1683 Ph: (408) 274-3881 |
| NPI Number | 1104261700 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 02/19/2014 |
| Medicare PECOS PAC ID | 0941430037 |
|---|---|
| Medicare Enrollment ID | O20140312000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104261700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A42236 (California) | Primary |
| Provider Name | Dung My Phan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912013780 PECOS PAC ID: 5991829921 Enrollment ID: I20100827000754 |
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