Thanhgia Phung Prairie Medical Group

NPI #1275832354 in Lawndale, California

Provider Information

NPI Number: 1275832354
Entity Type: Organization
Organization Name: Thanhgia Phung Prairie Medical Group
Primary Specialty: Pediatrics
Enumeration Date: Mar 15, 2011
Last Updated: Mar 15, 2011

Practice Location

Address: 15027 SOUTH PRAIRIE AVE
City: Lawndale
State: California
ZIP Code: 90260
Phone: (310) 970-9040

Authorized Official

Name: THANH GIA PHUNG, M.D.
Title: MEDICAL DIRECTOR
Phone: (310) 970-9040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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