Individual
THU PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGNP-C
Contact information
Practice address
9333 IMPERIAL HWY, DOWNEY, CA 90242-2812
(800) 823-4040
Mailing address
9333 IMPERIAL HWY, DOWNEY, CA 90242-2812
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
803544
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
95006018
CA
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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