Organization
CHRISTYN MAI PHAN O D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTYN MAI PHAN O.D. (PRESIDENT)
(714) 636-9200
Entity
Organization
Contact information
Practice address
9862 CHAPMAN AVE STE A, GARDEN GROVE, CA 92841-2726
(714) 636-9200
(714) 636-9424
Mailing address
9862 CHAPMAN AVE STE A, GARDEN GROVE, CA 92841-2726
(714) 636-9200
(714) 636-9424
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12640T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0126400
—
CA
Enumeration date
11/30/2006
Last updated
06/14/2021
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