MEDICARE: MS. CHRISTINE T. PHUA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DO034232	DC
2	207Q00000X	Family Medicine Physician	20A11736	CA

General Provider Information

NPI Number	:	1720262744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE T. PHUA D.O.

Provider Business Mailing Address
First Line	:	4908 BUCHANAN ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90042
Country	:	US
Telephone Number	:	323-540-4336
Fax Number	:	415-503-6099

Provider Business Practice Location Address
First Line	:	16714 CHERRY AVE
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504
Country	:	US
Telephone Number	:	323-540-4336
Fax Number	:	415-175-0767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	03/13/2026

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