Individual
QUANG QUOC PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12665 GARDEN GROVE BLVD, SUITE 304, GARDEN GROVE, CA 92843-1901
(714) 537-5302
(714) 537-0592
Mailing address
12665 GARDEN GROVE BLVD, SUITE 304, GARDEN GROVE, CA 92843-1901
(714) 537-5302
(714) 537-0592
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A44365
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A443651
—
CA
Enumeration date
09/07/2005
Last updated
07/08/2007
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