Healthcare Provider Details

I. General information

NPI: 1407821663
Provider Name (Legal Business Name): BY PHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S 9TH AVE
YAKIMA WA
98902-3315
US

IV. Provider business mailing address

732 SUMMITVIEW AVE #621
YAKIMA WA
98902-3032
US

V. Phone/Fax

Practice location:
  • Phone: 509-454-6194
  • Fax: 509-454-6187
Mailing address:
  • Phone: 509-573-3448
  • Fax: 509-574-4481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD00041414
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00041414
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: