Individual
BAO PHUC NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4541 PHILADELPHIA ST STE C103, CHINO, CA 91710-2250
(909) 590-7997
Mailing address
5252 LAUREL ST, SAN DIEGO, CA 92105-4913
(619) 632-2476
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
300348
CA
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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