Individual
LYANNE LAN PHUONG HUYNH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2505 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 957-7050
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A114058
CA
208M00000X
Hospitalist Physician
Primary
A114058
CA
Other
Enumeration date
09/29/2010
Last updated
05/07/2014
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