Active NPI
Matthew Quan Phan, PHARMD
- Pharmacist
- Mountain View, CA
National Provider Identifier
1336617828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79762
- Practice address
- 555 Showers Dr
Mountain View, CA 94040-4795 - Phone
- (650) 965-0129
- NPI assigned
- Nov 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79762 | CA | Primary |
Addresses
Primary practice location
555 Showers Dr
Mountain View, CA 94040-4795
Mailing address
PO Box 3357
Santa Clara, CA 95055-3357
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79762 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541116800000",
"number": "1336617828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3357",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950553357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 SHOWERS DR",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940404795",
"telephone_number": "650-965-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "MATTHEW",
"middle_name": "QUAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-02",
"last_updated": "2018-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.