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Organization
SAN BERNARDINO HEALTH MEDICAL GROUP INC
Active
Organization
SAN BERNARDINO HEALTH MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUONG THIEU PHUNG M.D. (OB/GYN)
(909) 591-1743
Entity
Organization
Contact information
Practice address
5365 WALNUT AVE, A, CHINO, CA 91710-2622
(909) 591-1743
(909) 591-1744
Mailing address
5365 WALNUT AVE, A, CHINO, CA 91710-2622
(909) 591-1743
(909) 591-1744
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0A705510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A705510
—
CA
Enumeration date
07/31/2006
Last updated
08/22/2020
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