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General NPI Number Information
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NPI Number | 1770660904
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Entity Type | Individual
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Provider Name | NARIN PHUONG PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2499 S WILMINGTON AVE
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City | COMPTON
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State | CA
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Zip | 90220-5434
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Country | US
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Telephone | 310-638-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 2851 E 57TH ST
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City | LONG BEACH
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State | CA
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Zip | 90805-5117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14748
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA14748
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License Number State | CA
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