Healthcare Provider Details

I. General information

NPI: 1295562148
Provider Name (Legal Business Name): SARAH BAO-TRAN PHAN PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2887 S MARKET ST
GILBERT AZ
85295-1303
US

IV. Provider business mailing address

1769 W LOS ARBOLES CT
CHANDLER AZ
85224-2232
US

V. Phone/Fax

Practice location:
  • Phone: 480-366-3959
  • Fax: 480-366-3956
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS027165
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: