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NPI Code Detail

MEDICARE: JESSICA PHAM

MEDICARE: JESSICA PHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist Assistant

General Provider Information

NPI Number : 1902611833
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA PHAM
Provider Business Mailing Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number : 404-778-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2025
Last Update Date : 12/09/2025

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Directions to “ JESSICA PHAM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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