Provider Demographics
NPI:1205065968
Name:PHOENIX BAPTIST HOSPITAL
Entity type:Organization
Organization Name:PHOENIX BAPTIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/INTERN
Authorized Official - Prefix:DR
Authorized Official - First Name:UYEN MICHELLE
Authorized Official - Middle Name:THUC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-887-0552
Mailing Address - Street 1:967 GALINDO COURT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035
Mailing Address - Country:US
Mailing Address - Phone:408-887-0552
Mailing Address - Fax:
Practice Address - Street 1:2000 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2443
Practice Address - Country:US
Practice Address - Phone:408-887-0552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital