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1548741176
DIEP PHAN
STOCKTON, CA
NPI
1548741176
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: CA 41006)
Enumeration Date
2018-08-22
Last Update Date
2018-08-22
Business Address
DIEP PHAN
7720 LORRAINE AVE STE 102
STOCKTON, CA 95210-4203
Phone number: 209-957-8787
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Mailing Address
DIEP PHAN
9485 HEINLEIN CT
SACRAMENTO, CA 95829-6094
Phone number:
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