Tuan Van Phan M.d., Inc. | |
1569 Lexann Ave Ste 120 San Jose CA 95121-1794 | |
(408) 270-4267 | |
(408) 270-3594 |
Full Name | Tuan Van Phan M.d., Inc. |
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Speciality | Family Medicine |
Location | 1569 Lexann Ave Ste 120, San Jose, California |
Authorized Official Name and Position | Tuan Van Phan (CEO) |
Authorized Official Contact | 4082704267 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tuan Van Phan M.d., Inc. 1569 Lexann Ave Ste 120 San Jose CA 95121-1794 Ph: (408) 270-4267 | Tuan Van Phan M.d., Inc. 1569 Lexann Ave Ste 120 San Jose CA 95121-1794 Ph: (408) 270-4267 |
NPI Number | 1134379183 |
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Provider Enumeration Date | 09/26/2008 |
Last Update Date | 06/10/2020 |
Medicare PECOS PAC ID | 3476688946 |
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Medicare Enrollment ID | O20100323000382 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134379183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Tuan V Phan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710081047 PECOS PAC ID: 3072648534 Enrollment ID: I20100323000324 |
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