Cong T. Phan M.d., Inc. | |
8235 Rochester Ave Ste 110 Rancho Cucamonga CA 91730-0719 | |
(909) 484-4900 | |
(909) 781-2949 |
Full Name | Cong T. Phan M.d., Inc. |
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Speciality | Internal Medicine |
Location | 8235 Rochester Ave Ste 110, Rancho Cucamonga, California |
Authorized Official Name and Position | Cong T. Phan (PRESIDENT) |
Authorized Official Contact | 9099414777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Cong T. Phan M.d., Inc. 9303 Jasmine Ave Fountain Valley CA 92708-1960 Ph: (909) 941-4777 | Cong T. Phan M.d., Inc. 8235 Rochester Ave Ste 110 Rancho Cucamonga CA 91730-0719 Ph: (909) 484-4900 |
NPI Number | 1114354396 |
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Provider Enumeration Date | 10/02/2013 |
Last Update Date | 09/25/2024 |
Medicare PECOS PAC ID | 8426031139 |
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Medicare Enrollment ID | O20040611000933 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114354396 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (California) | Primary |
Provider Name | Cong T Phan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1386778033 PECOS PAC ID: 1759364466 Enrollment ID: I20040720000815 |
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