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NPI Code Detail

MEDICARE: JASON CHANHTRUNG PHAN

MEDICARE: JASON CHANHTRUNG PHAN
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician20A24473CA

General Provider Information

NPI Number : 1083467765
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON CHANHTRUNG PHAN
Provider Business Mailing Address
First Line : 1700 MOUNT VERNON AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93306-4018
Country : US
Telephone Number : 661-326-2000
Fax Number : 661-862-7684
Provider Business Practice Location Address
First Line : 1700 MOUNT VERNON AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93306-4018
Country : US
Telephone Number : 661-326-2000
Fax Number : 661-862-7684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2024
Last Update Date : 06/20/2026

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Directions to “ JASON CHANHTRUNG PHAN ” Practice Location

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