Individual
ANH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1196 N PARK AVE, POMONA, CA 91768-3027
(909) 623-4050
Mailing address
4737 BANDERA ST, MONTCLAIR, CA 91763-4392
(909) 667-6608
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60377
CA
Other
Enumeration date
07/13/2020
Last updated
12/30/2021
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