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Individual

BENJERMIN FAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
3849 E FOOTHILL BLVD, PASADENA, CA 91107-2204
(626) 469-5433
Mailing address
3849 E FOOTHILL BLVD, PASADENA, CA 91107-2204

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95031818
CA
363LP0200X
Pediatric Nurse Practitioner
95031818
CA

Other

Enumeration date
11/24/2025
Last updated
12/04/2025
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