Search › California › 183500000X
Justin Phan
NPI 1700317229 · on the registry since 2017 · sole proprietor
Practice
- Address
- 10925 Goldeneye Ave
Fountain Valley, CA 92708 - Phone
- (714) 487-9265
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-03-26
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