Douglas M Phan
Otolaryngologist (ENT Doctor)
1541 Florida Ave Ste 304
Modesto
, California 95350-4439
Douglas M Phan
Otolaryngologist (ENT Doctor)
1541 Florida Ave Ste 304
Modesto
, California 95350-4439
(217) 223-8400
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
Languages spoken
- English
Location
First Address
- Douglas M Phan
- 927 Broadway St Suite 322
- Quincy, IL
- Zip : 62301-2719
- Phone : (217) 223-8400
Second Address
- Douglas M Phan
- 1541 Florida Ave Ste 304
- Modesto, CA
- Zip : 95350-4439
- Fax : (209) 521-3262
- Phone : (209) 577-3388
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G51181 | CA |
National Provider Identifier
| NPI | 1013073766 |
|---|---|
| Provider Name | Douglas M Phan |
| First Address | Quincy, IL 62301-2719 |
| Second Address | Modesto, CA 95350-4439 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/12/2006 |
| Last Update Date | 16/01/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.