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NPI Code Detail

MEDICARE: FELISA T PHAN

MEDICARE: FELISA T 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH50480CA

General Provider Information

NPI Number : 1326346859
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELISA T PHAN
Provider Business Mailing Address
First Line : 2201 SENTER RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-2627
Country : US
Telephone Number : 408-947-2055
Fax Number : 408-947-0178
Provider Business Practice Location Address
First Line : 2201 SENTER RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-2627
Country : US
Telephone Number : 408-947-2055
Fax Number : 408-947-0178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2011
Last Update Date : 03/08/2011

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Directions to “ FELISA T PHAN ” Practice Location

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