Healthcare Provider Details

I. General information

NPI: 1164370409
Provider Name (Legal Business Name): CHRISTINE DINH PHAM
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31700 TEMECULA PKWY STE 2
TEMECULA CA
92592-5896
US

IV. Provider business mailing address

31700 TEMECULA PKWY STE 2
TEMECULA CA
92592-5896
US

V. Phone/Fax

Practice location:
  • Phone: 951-304-7175
  • Fax:
Mailing address:
  • Phone: 951-304-7175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: