Provider Demographics
NPI:1356723605
Name:PACIFIC FAMILY MEDICINE CLINIC INC
Entity type:Organization
Organization Name:PACIFIC FAMILY MEDICINE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-689-5431
Mailing Address - Street 1:1001 BROADWAY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1977
Mailing Address - Country:US
Mailing Address - Phone:650-689-5431
Mailing Address - Fax:
Practice Address - Street 1:1001 BROADWAY
Practice Address - Street 2:SUITE 302
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1978
Practice Address - Country:US
Practice Address - Phone:415-975-1255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty