Phan, Quang Quoc

Phan, Quang Quoc is an sole proprietor health care provider with primary practice located at 12665 Garden Grove Blvd Suite 304, Garden Grove CA 92843-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Phan, Quang Quoc can be contacted via phone (714) 537-5302.

Contact Information

Primary practice address
12665 Garden Grove Blvd Suite 304 Garden Grove CA 92843-1901
Fax: (714) 537-0592
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X A44365 California

Profile Details

NPI number 1982698957
LBN Legal business name Phan, Quang Quoc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982698957 NPPES
California MEDICAID 00A443651

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