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Individual

TAI THIEN PHUNG

Active
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Individual

TAI THIEN PHUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
780978
CA
363L00000X
Nurse Practitioner
Primary
NP95019571
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—

Other

Enumeration date
09/21/2020
Last updated
03/16/2022
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