Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THEODORE THIEN PHAN
Active Sole ProprietorTHEODORE THIEN PHAN is a Physician Assistant healthcare provider located in NOVATO, California. NPI 1104546969 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · NOVATO, CA
Registration Details
- NPI Number
- 1104546969
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 31, 2022 (3.9231379459495 yrs)
- Last Updated
- Dec 5, 2022
- License
-
61808 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
52 TRINITY DRNOVATO, CA, 949475246Browse CA providers · Browse ZIP 94947
- Phone
- 4153202313
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in NOVATO, CA
| Name | Credential | NPI |
|---|---|---|
| MICHELE JODOIN | PA | 1346356383 |
| JULIE STANKOVIC | PA-C | 1760700702 |
| MR. KEVIN JUDE HOLMAN | PA-C | 1770849671 |
| MS. DARCIE ANN LARIMORE-ARENAS | PA | 1083969943 |
| SHIVANI VASISHTA | PA | 1750743555 |
| KIMYA BARADARAN | — | 1225671845 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.