Individual
BAO PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1538 E CHAPMAN AVE, ORANGE, CA 92866-2231
(714) 288-1790
Mailing address
1124 S ARAPAHO DR, SANTA ANA, CA 92704-2407
(714) 721-3483
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH74314
CA
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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