Individual provider Active NPI

Giang Huong Phan

  • Pharmacist
  • Medford, OR
National Provider Identifier
1215306212
Registry record updated Sep 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0014633 Issued in OR
Practice address
3615 Crater Lake Hwy
Medford, OR 97504-9259
Phone
(541) 227-5403
NPI assigned
Sep 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0014633 OR Primary

Addresses

Primary practice location

3615 Crater Lake Hwy
Medford, OR 97504-9259

Mailing address

3615 Crater Lake Hwy
Medford, OR 97504-9259
Phone (541) 227-5403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPH-0014633ORMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442707200000",
    "number": "1215306212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 CRATER LAKE HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049259",
            "telephone_number": "541-227-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 CRATER LAKE HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049259",
            "telephone_number": "541-227-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "GIANG HUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-20",
        "last_updated": "2015-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.