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General NPI Number Information
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NPI Number | 1164931911
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Entity Type | Individual
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Provider Name | MINH TUE THI PHAN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 13045 ROSEDALE HWY
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City | BAKERSFIELD
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State | CA
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Zip | 93314-9496
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Country | US
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Telephone | 661-587-0158
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Fax |
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Provider Business Mailing Address
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Address Line | 7726 STONY RIVER CT
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City | BAKERSFIELD
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State | CA
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Zip | 93308-6656
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Country | US
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Telephone | 626-757-6215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 76749
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License Number State | CA
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