MINH DUC PHAN (NPI# 1174148662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174148662 |
| Entity Type | Individual |
| Full Name | MINH DUC PHAN |
| Practice Address |
975 S Fairmont Ave Lodi CA 95240-5118 |
| Mailing Address |
10135 Tony Ct Stockton CA 95209-4578 |
| Practice Telephone | 2093397595 |
| Practice Fax Number | 2093697694 |
| Mailing Telephone | 2094069980 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 60175 | CA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265803050 | Minh Phan | Dentist | 31406 Weston Village Dr, Spring, TX 77386-2596 | 2015-10-19 |
| 1336372242 | Minh Ngoc Phan | Dentist | 4660 Coralwood Cir, Carlsbad, CA 92008-3708 | 2009-08-25 |
| 1699989103 | Minh V Phan | Dentist | 1305 S 312th St Ste 201, Federal Way, WA 98003-9028 | 2007-05-10 |
| 1417027186 | Minh H Phan | Dentist | 905 E Southmore, Pasadena, TX 77502 | 2006-11-09 |
| 1972120061 | Minh Phan | Physical Therapist | 10260 Main St, Fairfax, VA 22030-2404 | 2020-07-06 |
| 1306321096 | Minh Van Phan | Pharmacist | 1615 N Main St, Houston, TX 77009-8525 | 2018-09-27 |
| 1578083382 | Minh Phan | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2017-06-22 |
| 1124312343 | Minh Phan | Internal Medicine | 800 Ne 10th St Fl 6, Oklahoma City, OK 73104-5418 | 2011-06-06 |
| 1497900963 | Minh Huy Phan | Pharmacist | 27300 Iris Ave, Moreno Valley, CA 92555-4802 | 2008-11-24 |
| Street Address |
975 S FAIRMONT AVE |
| City | LODI |
| State | CA |
| Zip Code | 95240-5118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316938301 | Lodi Memorial Hospital Association Inc | General Acute Care Hospital | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2005-10-31 |
| 1710500848 | Sara Ghohestani-bojd | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-05-23 |
| 1245864297 | Kristin Jean Gedda | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-02-28 |
| 1124663539 | Ryan Hortum | Occupational Therapist | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-11-08 |
| 1023673167 | Diagnostic Pathology Medical Group Inc | Pathology | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-05-03 |
| 1295390672 | Armeghan Bagherpour | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-05-01 |
| 1730643768 | Hannah Esther Keller | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-01-23 |
| 1699242065 | Elizabeth Emily Bennett | Registered Nurse | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2018-10-24 |
| 1669970778 | Jason Rogers | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2018-01-24 |
| 1346752946 | Manpreet Kaur Gill | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2017-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019271 | Jaspal Singh Samra | Pharmacist | 1007 Interlaken Dr, Lodi, CA 95242-9174 | 2019-02-16 |
| 1578039376 | Kyle Hoi-kyu Kwong | Pharmacist | 850 S Guild Ave Ste 100, Lodi, CA 95240-3170 | 2018-10-18 |
| 1689047250 | Cvs Pharmacy | Pharmacist | 2053 Katnich Ln, Lodi, CA 95242-4805 | 2015-11-04 |
| 1417341934 | Alma Ochoa | Pharmacist | 4400 E Morse Rd, Lodi, CA 95240-6845 | 2015-03-23 |
| 1043616733 | Wilai Hammond | Pharmacist | 1701 S Mills Ave Apt 101, Lodi, CA 95242-4262 | 2014-11-07 |
| 1508270083 | Joe Y Vuong | Pharmacist | 339 E Pine St ., Lodi, CA 93312 | 2014-06-12 |
| 1922411826 | Ashok Kumar Punati | Pharmacist | 520 W Lodi, Lodi, CA 94568 | 2014-06-09 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1083983399 | Jennifer Cheng | Pharmacist | 554 Harrison Ave Fl 2, Lodi, NJ 07644-1137 | 2011-12-16 |
| 1417233016 | Gregg William Wellner | Pharmacist | N2360 Summerville Park Rd, Lodi, WI 53555-9621 | 2011-10-26 |
| Find all providers in LODI | ||||
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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.