Provider Demographics
NPI:1912127432
Name:PHAN, HAU DUC
Entity Type:Individual
Prefix:MR
First Name:HAU
Middle Name:DUC
Last Name:PHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8174 MADONNA CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-6368
Mailing Address - Country:US
Mailing Address - Phone:916-882-0810
Mailing Address - Fax:
Practice Address - Street 1:8174 MADONNA CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-6368
Practice Address - Country:US
Practice Address - Phone:916-882-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator