Phong Ta is a student in an organized health care education training program in San Jose, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Phong Ta NPI is 1083298509. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1721 CASTLEGATE DR
SAN JOSE, CA
ZIP 95132-712
Phone: (408) 821-9603
The enumeration date for this NPI number is 5/11/2021 and was last updated on 5/11/2021.