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NPI Code Detail

MEDICARE: DR. PETER SON PHAM M.D.

MEDICARE: DR. PETER SON PHAM M.D.
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
1207L00000XAnesthesiology PhysicianG86169CA

General Provider Information

NPI Number : 1972580868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER SON PHAM M.D.
Provider Business Mailing Address
First Line : PO BOX 25033
Second Line :
City : SANTA ANA
State : CA
Zip : 92799-5033
Country : US
Telephone Number : 714-347-1000
Fax Number : 714-347-1082
Provider Business Practice Location Address
First Line : 1225 WILSHIRE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1901
Country : US
Telephone Number : 213-977-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 09/18/2024

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Directions to “ DR. PETER SON PHAM M.D.” Practice Location

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