Individual
KENNY H PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT
Contact information
Practice address
13071 BROOKHURST ST STE 100, GARDEN GROVE, CA 92843-5514
(714) 425-9066
Mailing address
13071 BROOKHURST ST STE 100, GARDEN GROVE, CA 92843-5514
(714) 425-9066
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
2719
FL
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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