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Individual

DIANA T PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1740 W TAYLOR ST, 3200W UIH M/C515, CHICAGO, IL 60612-7232
(312) 996-4021
(312) 996-4019
Mailing address
21 LEE, IRVINE, CA 92620-6202
(312) 515-8056

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036140455
IL
207L00000X
Anesthesiology Physician
Primary
129197
CA

Other

Enumeration date
04/10/2012
Last updated
08/08/2016
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