Organization
DEREK Q PHAN MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK Q PHAN MD (PRESIDENT)
(951) 324-3157
Entity
Organization
Contact information
Practice address
800 S MAIN ST, CORONA, CA 92882-3420
(213) 569-1450
Mailing address
10798 JURUPA RD, PO BOX 136, JURUPA VALLEY, CA 91752
(213) 569-1450
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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