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NPI Code Detail

MEDICARE: JOSEPH K PHAN

MEDICARE: JOSEPH K 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
1225400000XRehabilitation PractitionerCA
2104100000XSocial Worker135853CA
3171M00000XCase Manager/Care CoordinatorCA

General Provider Information

NPI Number : 1205410131
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH K PHAN
Provider Business Mailing Address
First Line : 2670 S WHITE RD STE 200
Second Line :
City : SAN JOSE
State : CA
Zip : 95148-2073
Country : US
Telephone Number : 408-937-1553
Fax Number : 408-516-0053
Provider Business Practice Location Address
First Line : 2670 S WHITE RD STE 200
Second Line :
City : SAN JOSE
State : CA
Zip : 95148-2073
Country : US
Telephone Number : 408-937-1553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2021
Last Update Date : 02/10/2026

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Directions to “ JOSEPH K PHAN ” Practice Location

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