Individual
PHUONG ANH THI LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
2077 HARBOR BLVD STE 100, COSTA MESA, CA 92627-9384
(949) 740-7117
(949) 209-3955
Mailing address
2077 HARBOR BLVD STE 100, COSTA MESA, CA 92627-9384
(949) 740-7117
(949) 209-3955
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15064
CA
Other
Enumeration date
11/08/2006
Last updated
12/15/2025
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