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Individual

MS. LILY PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
80 SARATOGA AVE, SANTA CLARA, CA 95051-7303
(408) 351-6400
Mailing address
3976 PERIE LN, SAN JOSE, CA 95132-3226
(408) 477-9947

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NA
CA
Enumeration date
06/04/2019
Last updated
06/04/2019
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