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NPI Code Detail

MEDICARE: DR. THERESA PHAN PHARMD

MEDICARE:  DR. THERESA  PHAN  PHARMD
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
1183500000XPharmacist21878CO

General Provider Information

NPI Number : 1841850831
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THERESA PHAN PHARMD
Provider Business Mailing Address
First Line : 17590 E BAKER PL
Second Line :
City : AURORA
State : CO
Zip : 80013-4184
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3425 S CLARKSON ST
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-2899
Country : US
Telephone Number : 303-789-8584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2019
Last Update Date : 06/20/2019

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Directions to “ DR. THERESA PHAN PHARMD” Practice Location

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