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Individual

PHOENIX DI YING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3200 KEARNEY ST, FREMONT, CA 94538-2299
(510) 490-1222
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA57289
CA
363AS0400X
Surgical Physician Assistant
PENDING
CT

Other

Enumeration date
08/06/2018
Last updated
12/18/2019
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