Healthcare Provider Details

I. General information

NPI: 1922326958
Provider Name (Legal Business Name): YVONNE THANH-NGA D PHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 WINCHESTER AVE STE 230
KANSAS CITY MO
64133-4681
US

IV. Provider business mailing address

6601 WINCHESTER AVE STE 230
KANSAS CITY MO
64133-4681
US

V. Phone/Fax

Practice location:
  • Phone: 816-313-2677
  • Fax: 816-313-6000
Mailing address:
  • Phone: 816-313-2677
  • Fax: 816-313-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number04-40203
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2017022655
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: