Provider Demographics
NPI:1275932519
Name:PHAN, YU-CHIEH (PHARMD)
Entity Type:Individual
Prefix:
First Name:YU-CHIEH
Middle Name:
Last Name:PHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6233 W BEHREND DR
Mailing Address - Street 2:#3052
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7000 N 16TH ST
Practice Address - Street 2:SUITE #100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5547
Practice Address - Country:US
Practice Address - Phone:602-943-3192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist