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
Phone: (951) 737-5540
Fax: (951) 737-5549
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588624258 | NPPES |
| California | Other | B4239801 | DENTICAL |
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