Medical Board of California
Licensing details for: PTL 12979
Name: Ta, Minhtri Nguyen Phuc
License Type: Postgraduate Training License
Primary Status: License Canceled

School Name: Tulane University School of Medicine
Graduation Year: 2023
Previous Names: Ta, Minhtri
Current Enrolled Postgraduate Training Program
Facility Name: LOS ANGELES COUNTY-HARBOR-UCLA MEDICAL CENTER PROGRAM
City: Torrance
State: California
Speciality: Internal medicine
Start Date: 06/24/2023
Anticipated End Date: 09/23/2024
Address of Record
1000 W Carson St, Box 400
TORRANCE CA 90502-2004
LOS ANGELES county
Map
License Relationships
Postgraduate Training License associated with Physician & Surgeon License
License/Registration Role: Postgraduate Training License
Related Party Role: Physician & Surgeon
Name: Ta, Minhtri Nguyen Phuc
License/Registration Type: Physician's and Surgeon's
License Number: 206547 Primary Status: License Renewed & Current
Address :
4445 Magnolia Ave
RIVERSIDE CA 92501-4135
RIVERSIDE COUNTY



