Individual
DR. KHAI GIA PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
19501 NW 27TH AVE, MIAMI GARDENS, FL 33056-2521
(305) 974-2588
Mailing address
19501 NW 27TH AVE, MIAMI GARDENS, FL 33056-2521
(305) 974-2588
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014191100
—
FL
Enumeration date
03/30/2007
Last updated
03/05/2015
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