Individual
LOAN T PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 S HUNTINGTON AVE FL 6, BOSTON, MA 02130-4817
(857) 364-4327
Mailing address
150 S HUNTINGTON AVE FL 2, BOSTON, MA 02130-4817
(857) 364-4327
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1224
MA
Other
Enumeration date
06/14/2007
Last updated
05/17/2023
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