Healthcare Provider Details

I. General information

NPI: 1932899218
Provider Name (Legal Business Name): ANH HOANG LE PHAM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 ALBERTA AVE
EL PASO TX
79905-2707
US

IV. Provider business mailing address

20047 STRATHERN ST
WINNETKA CA
91306-2345
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-4460
  • Fax:
Mailing address:
  • Phone: 818-274-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10099244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: