Organization
UROLOGY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CU NGOC PHAN MD (PRESIDENT)
(949) 718-4315
Entity
Organization
Contact information
Practice address
1441 AVOCADO AVE, SUITE 408, NEWPORT BEACH, CA 92660-7721
(949) 718-4315
(949) 718-4316
Mailing address
1441 AVOCADO AVE, SUITE 408, NEWPORT BEACH, CA 92660-7721
(949) 718-4315
(949) 718-4316
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G64457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G644570
—
CA
Enumeration date
02/24/2012
Last updated
02/24/2012
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