Michelle C Phan, O.D. Valid NPI

Individual provider · Optometrist · Rancho Cucamonga, CA

NPI

1639324619

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

13625T (CA)

Sex

Female

Sole proprietor

No

Enumerated

2008-11-18

Last updated

2021-11-30