Individual
EI MON PHYU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N BRIDGE ST, VISALIA, CA 93291-5014
(877) 960-3426
Mailing address
5947 CINNABAR CT, NEWARK, CA 94560-3155
(510) 648-1149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
109512
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2023
Last updated
05/19/2026
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