| Quang Q Phan, Md, Facp, Inc | |
|
12665 Garden Grove Blvd Suite 304 Garden Grove CA 92843-1901 | |
| (714) 537-5302 | |
| Not Available |
| Full Name | Quang Q Phan, Md, Facp, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12665 Garden Grove Blvd, Garden Grove, California |
| Authorized Official Name and Position | Quang Phan (PRESIDENT) |
| Authorized Official Contact | 7145375302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quang Q Phan, Md, Facp, Inc 12665 Garden Grove Blvd Suite 304 Garden Grove CA 92843-1901 Ph: (714) 537-5302 | Quang Q Phan, Md, Facp, Inc 12665 Garden Grove Blvd Suite 304 Garden Grove CA 92843-1901 Ph: (714) 537-5302 |
| NPI Number | 1801007679 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2163618869 |
|---|---|
| Medicare Enrollment ID | O20101119000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801007679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A44365 (California) | Primary |
| Provider Name | Quang Phan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982698957 PECOS PAC ID: 5496844581 Enrollment ID: I20100928000773 |
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