Organization
MAGNOLIA IMAGING MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THANH PHUNG MD (PRESIDENT)
(714) 891-2259
Entity
Organization
Contact information
Practice address
17070 COLIMA RD # G, HACIENDA HEIGHTS, CA 91745-6781
(714) 891-2259
(714) 890-7030
Mailing address
14571 MAGNOLIA ST STE 101, WESTMINSTER, CA 92683-5575
(714) 891-2259
(714) 890-7030
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C42348
CA
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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