Provider Demographics
NPI:1831491166
Name:PHAN, ALAN KHANH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KHANH
Last Name:PHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 PLACENTIA AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3306
Mailing Address - Country:US
Mailing Address - Phone:949-574-4541
Mailing Address - Fax:949-574-4532
Practice Address - Street 1:330 PLACENTIA AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3306
Practice Address - Country:US
Practice Address - Phone:949-574-4541
Practice Address - Fax:949-574-4532
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist