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NPI Code Detail

MEDICARE: QUYNH TIEN Y PHAN

MEDICARE: QUYNH TIEN Y 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
1103K00000XBehavior Analyst1-18-30247CA

General Provider Information

NPI Number : 1134615867
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUYNH TIEN Y PHAN
Provider Business Mailing Address
First Line : 8885 RIO SAN DIEGO DR STE 340
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1669
Country : US
Telephone Number : 619-436-8203
Fax Number :
Provider Business Practice Location Address
First Line : 8885 RIO SAN DIEGO DR STE 340
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1669
Country : US
Telephone Number : 619-436-8203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2018
Last Update Date : 08/17/2021

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Directions to “ QUYNH TIEN Y PHAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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