Individual
MR. BOPHAL PHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 E VIRGINIA ST, #280, SAN JOSE, CA 95112
(408) 287-6200
(408) 998-1535
Mailing address
160 E VIRGINIA ST STE 100, SAN JOSE, CA 95112-5865
(408) 938-2137
(408) 998-1535
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
29401
CA
Other
Enumeration date
12/15/2006
Last updated
02/08/2023
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