Organization
T MAI PHAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TUYET-MAI PHAN M.D. (PRESIDENT)
(714) 775-4400
Entity
Organization
Contact information
Practice address
9500 BOLSA AVE, SUITE P, WESTMINSTER, CA 92683-5943
(714) 775-4400
(714) 775-0149
Mailing address
9500 BOLSA AVE, SUITE P, WESTMINSTER, CA 92683-5943
(714) 775-4400
(714) 775-0149
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G576701
—
CA
05
—
00G576702
—
CA
Enumeration date
11/18/2010
Last updated
11/18/2010
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