Healthcare Provider Details

I. General information

NPI: 1235239070
Provider Name (Legal Business Name): DOAN TRINH THUY PHAM DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 BESSIE AVE
TRACY CA
95376-3004
US

IV. Provider business mailing address

1521 BESSIE AVE
TRACY CA
95376-3004
US

V. Phone/Fax

Practice location:
  • Phone: 209-835-4276
  • Fax: 209-835-1017
Mailing address:
  • Phone: 209-835-4276
  • Fax: 209-835-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number661
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: