Phan, Tarchya Thao

Phan, Tarchya Thao is an individual health care provider with primary practice located at 2205 Vesper Cir Suite-103, Corona CA 92879-3501. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Phan, Tarchya Thao can be contacted via phone (951) 737-5540.

Contact Information

Primary practice address
2205 Vesper Cir Suite-103 Corona CA 92879-3501
Fax: (951) 737-5549
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 42398 California

Profile Details

NPI number 1588624258
LBN Legal business name Phan, Tarchya Thao
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Jul 8th, 2007 - about 17 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 1588624258 NPPES
California Other B4239801 DENTICAL

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