Healthcare Provider Details

I. General information

NPI: 1336061704
Provider Name (Legal Business Name): ANDREW PHAM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12110 HADLEY ST
WHITTIER CA
90601-3912
US

IV. Provider business mailing address

12110 HADLEY ST
WHITTIER CA
90601-3912
US

V. Phone/Fax

Practice location:
  • Phone: 877-602-7779
  • Fax: 866-853-6555
Mailing address:
  • Phone: 877-602-7779
  • Fax: 866-853-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: