Individual
SON PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8882 HILDRETH LN, STOCKTON, CA 95212-9428
(209) 825-3616
Mailing address
8882 HILDRETH LANE, STOCKTON, CA 95212
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
11/22/2006
Last updated
07/08/2007
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