Phat Tan Phan

Primary specialty

PharmacistTaxonomy code 183500000X

License

80453 Issued in CA

Practice address

11200 Olive Dr
Bakersfield, CA 93312-5840

Phone

(661) 588-0010

NPI assigned

May 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)
• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Bakersfield, CA
  • NPI 1790962660
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1629635305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 BELLE TER APT 4",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933093734",
            "telephone_number": "714-487-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 OLIVE DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933125840",
            "telephone_number": "661-588-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHAT",
        "middle_name": "TAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "80453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "80435",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Riteaid",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "11200 Olive Dr",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933125840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joe Phan, PHARMD
• Khanh C Phan, PHARMD
• Louis Quy Phan
• Minh Tue Thi Phan
• Nhatu Phan
• Tram Phan, NP
• Trent Van Phan, D.O.
• Phast Pharmacy
• Phast Pharmacy
• Phec Mso LLC

• Pharmacist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.