Individual
DR. JIMMY NINH HOANG PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 DIAMOND DR STE 103, LAKE ELSINORE, CA 92530-4495
(951) 981-3122
(951) 981-3123
Mailing address
425 DIAMOND DR STE 103, LAKE ELSINORE, CA 92530-4495
(951) 981-3122
(951) 981-3123
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
141765
CA
Other
Enumeration date
05/02/2013
Last updated
01/27/2022
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