Healthcare Provider Details

I. General information

NPI: 1609309327
Provider Name (Legal Business Name): VICTORIA PHAM KIM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 S BRISTOL ST STE 110
SANTA ANA CA
92704-6210
US

IV. Provider business mailing address

2720 S BRISTOL ST STE 110
SANTA ANA CA
92704-6210
US

V. Phone/Fax

Practice location:
  • Phone: 714-458-9516
  • Fax:
Mailing address:
  • Phone: 877-462-2582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: