Individual
DR. JACKIE PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 SULLIVAN AVE, DALY CITY, CA 94015-2200
(650) 991-6816
Mailing address
1900 SULLIVAN AVE, DALY CITY, CA 94015-2200
(650) 991-6816
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A109180
CA
Other
Enumeration date
02/05/2009
Last updated
05/03/2013
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