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NPI Code Detail

MEDICARE: QUYNH NGOC PHAN

MEDICARE: QUYNH NGOC 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

General Provider Information

NPI Number : 1750236899
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUYNH NGOC PHAN
Provider Business Mailing Address
First Line : 4801 E LINWOOD BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4801 E LINWOOD BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number : 816-922-4872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ QUYNH NGOC PHAN ” Practice Location

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