Individual
LAURA T PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20398 BLAUER DR, SARATOGA, CA 95070-4307
(408) 502-5000
(408) 502-5505
Mailing address
20398 BLAUER DR, SARATOGA, CA 95070-4307
(408) 502-5000
(408) 502-5505
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301097337
MI
207W00000X
Ophthalmology Physician
A126463
CA
207W00000X
Ophthalmology Physician
D72821
MD
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
A126463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047445200
—
MD
Enumeration date
06/29/2007
Last updated
11/18/2024
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