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NPI Code Detail

MEDICARE: DR. CHINH PHAN D.O.

MEDICARE:  DR. CHINH  PHAN  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician20A11954CA
2207R00000XInternal Medicine Physician20A11954CA
3207RC0200XCritical Care Medicine (Internal Medicine) Physician20A11954CA

General Provider Information

NPI Number : 1881820876
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHINH PHAN D.O.
Provider Business Mailing Address
First Line : 2279 45TH ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1514
Country : US
Telephone Number : 916-734-5959
Fax Number :
Provider Business Practice Location Address
First Line : 2279 45TH ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1514
Country : US
Telephone Number : 916-734-5959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 09/19/2018

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Directions to “ DR. CHINH PHAN D.O.” Practice Location

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