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General NPI Number Information
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NPI Number | 1124663455
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Entity Type | Organization
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Legal Business Name | PHYSICIAN AT HOME INC
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 7923 GARDEN GROVE BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92841-4225
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Country | US
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Telephone | 714-596-0368
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Fax | 714-591-8265
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Provider Business Mailing Address
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Address Line | 5907 CERRITOS AVE UNIT 2325
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City | CYPRESS
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State | CA
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Zip | 90630-8716
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Country | US
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Telephone | 714-799-5858
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Fax | 714-799-7272
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | VU D TRAN
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Credential | MD
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Telephone | 714-496-4207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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