Search › California › 1223X0400X
H. Derick Phan, D.D.S., C.A.G.S
NPI 1609075910 · on the registry since 2007 · sole proprietor
Practice
- Address
- 11040 Bollinger Canyon Rd
Suite K
San Ramon, CA 94582 - Phone
- (925) 648-8588
- Fax
- (925) 648-8008
- Organisation at this address
- Revelcare Llc
Sweet Mango Therapy Group, Licensed Clinical Social Worker, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 21
Registry record
- Primary taxonomy
- 1223X0400X
1223X0400X
- Also registered as
- 1223X0400X
- Licence states on file
- AZ, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2008-07-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California