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NPI Code Detail

MEDICARE: JOANNE T PHAN PHARM.D

MEDICARE: JOANNE T PHAN PHARM.D
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
1183500000XPharmacist67861CA

General Provider Information

NPI Number : 1467826040
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE T PHAN PHARM.D
Provider Business Mailing Address
First Line : 1380 S 43RD ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-3408
Country : US
Telephone Number : 619-263-8116
Fax Number : 619-263-1989
Provider Business Practice Location Address
First Line : 1380 S 43RD ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-3408
Country : US
Telephone Number : 619-263-8116
Fax Number : 619-263-1989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2015
Last Update Date : 11/19/2015

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Directions to “ JOANNE T PHAN PHARM.D” Practice Location

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