PHONG PHAN (NPI# 1710518915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710518915 |
| Entity Type | Individual |
| Full Name | PHONG PHAN |
| Credential | PHARM.D |
| Practice Address |
84 010 Avenue 50 Coachella CA 92236 |
| Mailing Address |
1124 S Arapaho Dr Santa Ana CA 92704-2407 |
| Practice Telephone | 7603915656 |
| Mailing Telephone | 7146236607 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 80481 | CA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275566846 | Phong Thanh Phan | Internal Medicine | 200 Fleetwood Dr, Easley, SC 29640-2022 | 2006-07-08 |
| Street Address |
84 010 AVENUE 50 |
| City | COACHELLA |
| State | CA |
| Zip Code | 92236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518511500 | Sally Mireles | Counselor | 84109 La Jolla, Coachella, CA 92236 | 2019-07-29 |
| 1174185318 | Laura Castillo-dominguez | Licensed Vocational Nurse | 83113 Los Cabos Ave, Coachella, CA 92236 | 2019-07-08 |
| 1003390519 | Jennifer Le | Registered Nurse | 49-111 Ca-111 #6a, Coachella, CA 92236 | 2018-09-20 |
| 1700302502 | Latino Commission On Alcohol and Drug Abuse Services | Marriage & Family Therapist | 1612 First St., Coachella, CA 92236 | 2017-08-14 |
| 1467993279 | Jose Ramon Ledezma | Prosthetic/Orthotic Supplier | 84475 Goya Dr, Coachella, CA 92236 | 2017-03-13 |
| 1144622432 | Telecare Corporation | Psychiatric Unit | 49-708 Redondo Poniente, Coachella, CA 92236 | 2014-09-18 |
| 1851708762 | Juanita Ferro | Psychiatric Unit | 52371 Dos Palmas, Coachella, CA 92236 | 2014-07-14 |
| 1932519964 | Gloria Graham | Family Medicine | 50249 Harrison St, Coachella, CA 92236 | 2014-04-29 |
| 1326489121 | Alma Elizabeth Guadarrama Hernandez | Social Worker | 49211 Grapefruit Blvd Ste 5&6, Coachella, CA 92236 | 2013-07-10 |
| 1467621185 | Mark A Gillispie O D Inc | Eyewear Supplier (Equipment, not the service) | 52565 Harrison St., Suite 105, Coachella, CA 92236 | 2008-02-27 |
| Find all providers in zip 92236 | ||||
| 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 |
|---|---|---|---|---|
| 1376831719 | Philip Nathanson | Pharmacist | 5110 Harrison Street, Coachella, CA 92236-1560 | 2011-07-19 |
| 1376837518 | Chandra N Patel | Pharmacist | 49281 Grapefruit Blvd Ste 2, Coachella, CA 92236-1486 | 2011-06-06 |
| 1396065066 | Mary Lynsey Chong Lu | Pharmacist | 51101 Harrison St, Coachella, CA 92236-1560 | 2010-06-04 |
| 1609071745 | Quyen Thuc Tran | Pharmacist | 83053 Ave 48, Coachella, CA 92236 | 2007-06-19 |
| 1346853694 | Febey Shokralla | Pharmacist | 50040 Harrison St, Coachella, CA 92236 | 2020-08-26 |
| 1811510233 | Emmarance Verheem | Pharmacist | 51101 Cesar Chavez St, Coachella, CA 92236-1560 | 2020-05-20 |
| 1326679259 | Doreen Tudor | Pharmacist | 84010 Avenue 50, Coachella, CA 92236-9661 | 2020-01-29 |
| 1942860721 | Michael Garispe | Pharmacist | 49281 Grapefruit Blvd Ste 2, Coachella, CA 92236-1486 | 2019-06-14 |
| 1598220683 | Cheyenne Reveche Pillow | Pharmacist | 51101 Harrison St, Coachella, CA 92236-1560 | 2019-02-04 |
| 1972077717 | Vi Thai | Pharmacist | 51101 Harrison St, Coachella, CA 92236-1560 | 2019-01-15 |
| Find all providers in COACHELLA | ||||
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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.