Individual
KEVIN HT PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8805 HAVEN AVE STE 200, RANCHO CUCAMONGA, CA 91730-5157
(909) 912-1750
(909) 989-4477
Mailing address
1801 ORANGE TREE LN STE 200, REDLANDS, CA 92374-4587
(909) 557-1600
(909) 557-1732
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301501266
MI
Other
Enumeration date
04/17/2014
Last updated
06/06/2021
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