Search › California › 183500000X
Ngoc Thao Phan
NPI 1386174639 · on the registry since 2017 · sole proprietor
Practice
- Address
- 880 Sir Francis Drake Blvd
San Anselmo, CA 94960 - Phone
- (415) 456-4442
- Organisation at this address
- Longs Drug Stores California Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 8
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Also registered as
- 172V00000X
- Licence states on file
- CA, NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-09-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California