Healthcare Provider Details

I. General information

NPI: 1427733641
Provider Name (Legal Business Name): DON PHAM, CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 N MONTGOMERY ST
OJAI CA
93023-2746
US

IV. Provider business mailing address

302 N MONTGOMERY ST
OJAI CA
93023-2746
US

V. Phone/Fax

Practice location:
  • Phone: 805-646-9355
  • Fax:
Mailing address:
  • Phone: 805-646-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHERYL ANDERS
Title or Position: CTO
Credential:
Phone: 805-646-9355