Healthcare Provider Details

I. General information

NPI: 1194638403
Provider Name (Legal Business Name): TRUNG PHAM MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9411 BOLSA AVE STE B
WESTMINSTER CA
92683-5980
US

IV. Provider business mailing address

9411 BOLSA AVE STE B
WESTMINSTER CA
92683-5980
US

V. Phone/Fax

Practice location:
  • Phone: 714-559-3846
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TRUNG PHAM
Title or Position: PRESIDENT
Credential: MD
Phone: 669-252-4724