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Individual

RICKY NGUYEN PHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ACNP

Contact information

Practice address
13591 BOWEN ST, GARDEN GROVE, CA 92843-3223
(714) 261-7813
(714) 261-7813
Mailing address
13591 BOWEN ST, GARDEN GROVE, CA 92843-3223
(714) 261-7813

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95006779
CA

Other

Enumeration date
06/24/2017
Last updated
11/29/2017
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