Organization
HAI T PHAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAI T PHAN MD (OWNER)
(909) 883-9283
Entity
Organization
Contact information
Practice address
7223 CHURCH ST, SUITE A-20, HIGHLAND, CA 92346-5869
(909) 883-9283
(909) 886-6704
Mailing address
7223 CHURCH ST, SUITE A-20, HIGHLAND, CA 92346-5869
(909) 883-9283
(909) 886-6704
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0092866
—
CA
Enumeration date
10/11/2005
Last updated
12/12/2012
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