DR. MARTIN PHAN (NPI# 1063994879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063994879 |
| Entity Type | Individual |
| Full Name | DR. MARTIN PHAN |
| Credential | MD |
| Practice Address |
2995 Edison Dr San Jose CA 95133-2412 |
| Practice Telephone | 4085159029 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
3442 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2995 EDISON DR |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95133-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939841 | Ngan Kim Vo | Registered Nurse | 858 Gateview Ct, San Jose, CA 95133 | 2020-07-19 |
| 1508336686 | Andrew Jang | Behavior Technician | 75 E. Santa Clara St, San Jose, CA 95133 | 2018-11-30 |
| 1699269811 | Livleen Moore | Behavioral Analyst | 2828 Rainview Dr, San Jose, CA 95133 | 2018-06-20 |
| 1023526134 | Suman Sra Dds Inc | Dentist | 750 N Capitol Ave, Suite C-1, San Jose, CA 95133 | 2018-01-11 |
| 1861919797 | Maseume Quartararo | Social Worker | 1650 Las Plumas Avenue Suite K, San Jose, CA 95133 | 2017-08-22 |
| 1447789623 | San Jose Eye Care Optometry Professional Corporation | Optometrist | 301 N. Jackson Ave #1, San Jose, CA 95133 | 2017-06-09 |
| 1518336452 | Hung Tran | Pharmacist | 650 N Jackson Ave Apt 12, San Jose, CA 95133 | 2015-09-22 |
| 1487993507 | Taoyuan Chen | Acupuncturist | 866 Cape Verde Place, Sanjose, CA 95133 | 2013-02-08 |
| 1598021099 | Caminar | Community/Behavioral Health | 591 North King Rd, Suite 1, San Jose, CA 95133 | 2012-04-09 |
| 1922375070 | Hao Rong | Dentist | 1722 Commodore Dr., San Jose, CA 95133 | 2011-11-17 |
| Find all providers in zip 95133 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144732397 | Advanced Ep Diagnostics, Inc. | Specialist/Technologist, Other | 2550 Samaritan Dr Ste D, San Jose, CA 95124-4104 | 2017-10-27 |
| 1811263650 | Geoffrey Bush | Specialist/Technologist, Other | 2105 Forest Ave, San Jose, CA 95128 | 2012-03-27 |
| 1255420329 | Advanced Respiratory & Sleep Medicine, Inc | Specialist/Technologist, Other | 105 N Bascom Ave Ste 202, San Jose, CA 95128-1811 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996296 | Kelly Olivia Brand | Specialist/Technologist, Other | 11044 Tennessee Ave, Los Angeles, CA 90064-1966 | 2020-06-09 |
| 1417576901 | Alpha Neuro-monitoring, LLC | Specialist/Technologist, Other | 751 E Blithedale Ave # 369, Mill Valley, CA 94941-1515 | 2020-04-14 |
| 1386276624 | Pinpoint Monitoring LLC | Specialist/Technologist, Other | 73521 Jameson Rd, Palm Desert, CA 92211-2031 | 2020-02-05 |
| 1255986329 | Hope Diagnostics Inc | Specialist/Technologist, Other | 10999 Riverside Dr 204, North Hollywood, CA 91602-2239 | 2019-08-06 |
| 1982267001 | California Diagnostic Specialists, Inc. | Specialist/Technologist, Other | 9191 Westminster Ave # 209, Garden Grove, CA 92844-2751 | 2019-04-15 |
| 1083174213 | Svetlana Almeida | Specialist/Technologist, Other | 28201 La Plumosa, Laguna Niguel, CA 92677-7049 | 2019-03-22 |
| 1629535604 | Diego Bautista | Specialist/Technologist, Other | 324 S Beverly Drive #214, Beverely Hills, CA 90212 | 2019-02-26 |
| 1184191256 | Satellite Medical LLC | Specialist/Technologist, Other | 3478 Buskirk Ave Ste 140, Pleasant Hill, CA 94523-4383 | 2018-10-26 |
| 1285123588 | Vincent Mattiello | Specialist/Technologist, Other | 13924 Marquesas Way Apt 2302, Marina Del Rey, CA 90292-6020 | 2018-05-02 |
| 1013418011 | Julie Bloomfield | Specialist/Technologist, Other | 6645 Elegant Tern Pl, Carlsbad, CA 92011-2640 | 2018-02-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.