Individual
SARAH THAO PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2420 FENTON ST, CHULA VISTA, CA 91914-3516
(619) 498-6598
Mailing address
2420 FENTON ST, CHULA VISTA, CA 91914-3516
(619) 498-6598
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
713094
CA
363LF0000X
Family Nurse Practitioner
95025640
CA
Other
Enumeration date
06/04/2022
Last updated
07/04/2025
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