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NPI Code Detail

MEDICARE: KHANH PHUNG

MEDICARE: KHANH PHUNG
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
1207R00000XInternal Medicine PhysicianOS024157PA

General Provider Information

NPI Number : 1053704593
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHANH PHUNG
Provider Business Mailing Address
First Line : 41 UNIVERSITY DR STE 300
Second Line :
City : NEWTOWN
State : PA
Zip : 18940-1873
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1407 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-2803
Country : US
Telephone Number : 267-957-7027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2015
Last Update Date : 12/06/2024

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Directions to “ KHANH PHUNG ” Practice Location

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