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Organization
PACIFIC DX IDTF
Active
Organization
PACIFIC DX IDTF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYN J HENDERSON DO (AUTHORIZED OFFICIAL)
(714) 741-0622
Entity
Organization
Contact information
Practice address
13312 EUCLID ST, GARDEN GROVE, CA 92843
(714) 741-0622
(714) 741-0623
Mailing address
13312 EUCLID ST, GARDEN GROVE, CA 92843
(714) 741-0622
(714) 741-0623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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