Individual
SON PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7890
Mailing address
11201 BENTON ST # 114, LOMA LINDA, CA 92357-1000
(909) 825-7084
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
102974
CA
Other
Enumeration date
01/01/2007
Last updated
10/04/2025
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