Organization
MAI TUYET PHAN MEDICAL CLINIC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAI TUYET PHAN M.D. (M.D.)
(818) 342-8171
Entity
Organization
Contact information
Practice address
18625 SHERMAN WAY, SUITE 104, RESEDA, CA 91335-4148
(818) 342-8171
Mailing address
18625 SHERMAN WAY, SUITE 104, RESEDA, CA 91335-4148
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
A51466
CA
Other
Enumeration date
01/13/2011
Last updated
10/07/2011
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