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Mr. Sourigna Berna Phan
Massage Therapist in Corona, California
NPI 1972024792

Sourigna Berna Phan is a Massage Therapist based in Corona, CA. Sourigna Berna Phan practices in Corona, CA. The NPI Number for Sourigna Berna Phan is 1972024792 and holds a License No. 70935 (California).

The current practice location address for Sourigna Berna Phan is 800 Magnolia Ave Ste 105, Corona, CA and can be reached out via phone at 951-905-0454.

Location: 800 Magnolia Ave Ste 105, Corona, CA, 92879-3123
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972024792
Provider Name
Sourigna Berna Phan
Credential
Provider Entity Type
Individual
Gender
Male
Address
800 Magnolia Ave Ste 105, Corona, CA, 92879-3123
Phone Number
951-905-0454
Fax Number
Provider Enumeration Date
06/30/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
800 Magnolia Ave Ste 105
City
Corona
State
California
Zip
92879-3123
Phone Number
951-905-0454
Fax Number
person
Provider Business Mailing Address Details
Address
800 Magnolia Ave Ste 105
City
Corona
State
California
Zip
92879-3123
Phone Number
951-905-0454
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
70935 (California)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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