Individual
DOUGLAS M PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1541 FLORIDA AVE STE 304, MODESTO, CA 95350-4439
(209) 577-3388
(209) 521-3262
Mailing address
927 BROADWAY ST, SUITE 322, QUINCY, IL 62301-2719
(217) 223-8400
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G51181
CA
Other
Enumeration date
12/28/2006
Last updated
01/16/2019
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