Individual
MASON HIEU PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON STREET, WESTERLY C, LOMA LINDA, CA 92354
(909) 558-4000
Mailing address
11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE C, LOMA LINDA, CA 92354-2804
(909) 558-7814
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A182123
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/29/2021
Last updated
02/11/2026
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