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General NPI Number Information
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NPI Number | 1841353695
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Entity Type | Organization
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Legal Business Name | YEN BICH PHAN DDS PC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 S HARBOR BLVD SUITE A
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City | SANTA ANA
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State | CA
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Zip | 92704
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Country | US
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Telephone | 714-531-3405
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Fax | 714-531-3362
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Provider Business Mailing Address
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Address Line | 120 S HARBOR BLVD A
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City | SANTA ANA
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State | CA
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Zip | 92704
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Country | US
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Telephone | 714-531-3405
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Fax | 714-531-3362
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS YEN BICH PHAN
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Credential | DDS
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Telephone | 714-249-0558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41772
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License Number State | CA
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