Organization
DR JULIE PHAN OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE PHAN O.D. (OPTOMETRIST)
(909) 799-3130
Entity
Organization
Contact information
Practice address
1055 HARRIMAN PL, SAN BERNARDINO, CA 92408-4203
(909) 799-3130
Mailing address
13250 DON JULIAN RD, LA PUENTE, CA 91746-2239
(626) 382-9096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14612TLG
CA
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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