Individual
DR. DIEM PHUC THUC BANH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
26520 CACTUS AVE, GME OFFICE ROOM A1005, MORENO VALLEY, CA 92555-3927
(951) 486-5908
(951) 486-5901
Mailing address
26520 CACTUS AVE, GME OFFICE ROOM A1005, MORENO VALLEY, CA 92555-3927
(951) 486-5908
(951) 486-5901
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102204489
VA
Other
Enumeration date
06/21/2011
Last updated
12/22/2021
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