Individual
DR. CONG THANH PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8235 ROCHESTER AVE STE 110, RANCHO CUCAMONGA, CA 91730-0719
(909) 484-4900
(909) 781-2949
Mailing address
8235 ROCHESTER AVE STE 110, RANCHO CUCAMONGA, CA 91730-0719
(909) 484-4900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
00A780920
—
207R00000X
Internal Medicine Physician
Primary
A780920
CA
Other
Enumeration date
03/15/2007
Last updated
09/27/2024
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