RICKY PHONG TAN MAC

LONG BEACH, CA
NPI1578581666
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
(Licence: CA  A68178)
Enumeration Date2006-07-17
Last Update Date2012-05-22
Business Address
-- RICKY PHONG TAN MAC MD
1868 PACIFIC AVE
LONG BEACH, CA 90806-6113
Phone number: 562-595-4718
Mailing Address
-- RICKY PHONG TAN MAC MD
PO BOX 9576
ANAHEIM, CA 92812-7576
Phone number: