LAURA T PHAN (NPI# 1538366984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538366984 |
Entity Type | Individual |
Full Name | LAURA T PHAN |
Credential | MD |
Practice Address |
15055 Los Gatos Blvd Suite 320 Los Gatos CA 95032-2083 |
Practice Telephone | 6505875000 |
Mailing Telephone | 6505875000 |
Enumeration Date | 2007-06-29 |
Last Update Date | 2017-03-07 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207W00000X | Ophthalmology | A126463 | CA | Allopathic & Osteopathic Physicians |
N | 207W00000X | Ophthalmology | D72821 | MD | Allopathic & Osteopathic Physicians |
N | 207W00000X | Ophthalmology | 4301097337 | MI | Allopathic & Osteopathic Physicians |
Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
A126463 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | 047445200 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376996454 | Laura Ann Phan | Pharmacist | 213 Quarry Rd, Room 2726a, Palo Alto, CA 94304-1416 | 2016-07-13 |
Street Address |
15055 LOS GATOS BLVD SUITE 320 |
City | LOS GATOS |
State | CA |
Zip Code | 95032-2083 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588722680 | Iris Gin | Dermatology | 15055 Los Gatos Blvd, Suite 100, Los Gatos, CA 95032-2083 | 2006-12-04 |
1770964504 | Michelle Gough | Nurse Practitioner | 15055 Los Gatos Blvd, Ste 250, Los Gatos, CA 95032-2083 | 2015-06-17 |
1174957765 | Laura Phan, Md, Inc | Clinic/Center | 15055 Los Gatos Blvd, Suite 320, Los Gatos, CA 95032-2083 | 2013-08-30 |
1992077192 | Vital Health Institute | Specialist | 15055 Los Gatos Blvd, Suite 250, Los Gatos, CA 95032-2083 | 2012-02-02 |
1962638569 | Camilla Flemate | Physician Assistant | 15055 Los Gatos Blvd, Suite 100, Los Gatos, CA 95032-2083 | 2009-06-09 |
1114167582 | Linda Mavity | Nurse Practitioner | 15055 Los Gatos Blvd, Suite 250, Los Gatos, CA 95032-2083 | 2009-02-25 |
1538312251 | Tom Sheng Liu | Surgery | 15055 Los Gatos Blvd, Suite 250, Los Gatos, CA 95032-2083 | 2008-10-25 |
1215194808 | Jerome H Liu | Plastic Surgery | 15055 Los Gatos Blvd, Suite 250, Los Gatos, CA 95032-2083 | 2008-05-21 |
1891993556 | Denise Marie Alberto | Physical Therapist | 15055 Los Gatos Blvd, Suite 205, Los Gatos, CA 95032-2083 | 2007-07-04 |
1356483549 | Iris Gin Md and Rodney Gin Md | Dermatology | 15055 Los Gatos Blvd, Suite 100, Los Gatos, CA 95032-2083 | 2007-02-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346730157 | Stephanie Chui | Optometrist | 15055 Los Gatos Blvd Ste 300, Los Gatos, CA 95032 | 2018-05-16 |
1710474960 | Lisa Richardson | Dietitian, Registered | 15405 Los Gatos Blvd #101, Los Gatos, CA 95032 | 2018-04-13 |
1235652934 | Nillofar Tabibi | Pharmacist | 1496 Pollard Road, Los Gatos, CA 95032 | 2017-07-25 |
1609397694 | Taylor Dolores Peterson | Marriage & Family Therapist | 15495 Los Gatos Blvd Ste 5, Los Gatos, CA 95032 | 2017-06-29 |
1942755418 | Michelle Sunalp | Physician Assistant | 14830 Los Gatos Blvd, Suite 300, Los Gatos, CA 95032 | 2016-08-24 |
1295196640 | Mandice Williams | Chiropractor | 236 Oak Meadow Dr, Los Gatos, CA 95032 | 2016-03-14 |
1922465020 | Los Gatos Dental Specialists | Dentist | 15075 Los Gatos Blvd, Ste 120, Los Gatos, CA 95032 | 2016-01-20 |
1962881813 | Los Gatos Snf, LLC | Skilled Nursing Facility | 16605 Lark Ave., Los Gatos, CA 95032 | 2015-05-26 |
1720404312 | Jonathan Davies | Physician Assistant | 15466 Los Gatos Blvd Ste 109-353, Los Gatos, CA 95032 | 2014-03-06 |
1588002612 | Jessica Velasco Gutierrez | Licensed Vocational Nurse | 634 W Parr Ave #116, Los Gatos, CA 95032 | 2013-06-11 |
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Taxonomy Code | 207WX0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
Specialization | Ophthalmic Plastic and Reconstructive Surgery |
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366941296 | Guy G Massry, Md | Ophthalmology | 150 N Robertson Blvd Ste 314, Beverly Hills, CA 90211-2145 | 2018-02-06 |
1316483225 | Catherine Cox, Md, Inc | Ophthalmology | 711 D St Ste 102, San Rafael, CA 94901-3703 | 2017-01-17 |
1841734084 | Marlon Maus | Ophthalmology | 2616 Etna St, Berkeley, CA 94704-3409 | 2016-12-07 |
1538399761 | California Eye and Facial Plastic Surgery | Ophthalmology | 1812 Port Abbey Pl, Newport Beach, CA 92660-5310 | 2009-07-22 |
1790943355 | Roya Ghafouri | Ophthalmology | 9735 Wilshire Blvd Ste 421, Beverly Hills, CA 90212-2113 | 2008-05-29 |
1134395205 | Jeffrey Joseph | Ophthalmology | 180 Newport Center Dr Ste 158, Newport Beach, CA 92660-0934 | 2008-05-07 |
1013940519 | Medical Vision Technology Ophthalmology Grp Inc. | Ophthalmology | 1700 Alhambra Blvd, Suite 202, Sacramento, CA 95816-7050 | 2006-07-08 |
1609809144 | Medical Vision Technology Ophthalmology Grp, Inc | Ophthalmology | 1830 Sierra Gardens Dr, Suite 100, Roseville, CA 95661-2942 | 2006-07-08 |
1841292257 | Jeremiah Tao | Ophthalmology | 850 Health Sciences Rd, Irvine, CA 92697-4375 | 2005-08-15 |
1053938175 | Kelsey Andrea Roelofs | Ophthalmology | 100 Stein Plz, Los Angeles, CA 90095-7065 | 2020-07-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.