Individual
MISS DUNG NGOC PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
4776 EL CAJON BLVD, STE 105, SAN DIEGO, CA 92115-4521
(619) 287-1206
Mailing address
4776 EL CAJON BLVD, STE 105, SAN DIEGO, CA 92115-4521
(619) 287-1206
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH 47041
CA
3336C0003X
Community/Retail Pharmacy
Primary
RPH47041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA435300
—
CA
Enumeration date
06/20/2005
Last updated
03/11/2022
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