Individual provider · NPI-1

Hong Phan

Dental Assistant · Oakland, CA

NPI number1144633959
StatusActive
Last updated in NPPESJun 9, 2014

Details

NPI
1144633959
Entity type
Individual (NPI-1)
Name
Hong Phan
Sex
Female
Sole proprietor
No
Enumeration date
Jun 9, 2014
Last updated
Jun 9, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant75326CAYes

Practice location

2950 International Blvd
Oakland, CA 94601-2228

Phone 510-535-4453 · Fax 510-535-4494

Mailing address

2956 Rollingwood Dr
San Pablo, CA 94806-3227

Phone 510-734-3333

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