Healthcare Provider Details

I. General information

NPI: 1477354090
Provider Name (Legal Business Name): LILLIAN PHAM DACCHM, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 SAWTELLE BLVD
LOS ANGELES CA
90066-1408
US

IV. Provider business mailing address

6432 SETTING SUN DR
HUNTINGTON BEACH CA
92648-6715
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-9018
  • Fax:
Mailing address:
  • Phone: 714-837-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: