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Organization
LA MAGNOLIA MEDICAL GROUP
Active
Organization
LA MAGNOLIA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YENCHI NGUYEN PHUC MD (PRESIDENT)
(714) 894-3103
Entity
Organization
Contact information
Practice address
14571 MAGNOLIA ST. #210, WESTMINSTER, CA 92683
(714) 894-3103
(714) 894-6264
Mailing address
14571 MAGNOLIA ST. #210, WESTMINSTER, CA 92683
(714) 894-3103
(714) 894-6264
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A40020
CA
208000000X
Pediatrics Physician
Primary
G63064
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093500
—
CA
Enumeration date
08/30/2006
Last updated
06/14/2013
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