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General NPI Number Information
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NPI Number | 1144049800
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Entity Type | Individual
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Provider Name | MS. ANH THU PHAM
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Gender | Female
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 9778 KATELLA AVE STE 106
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City | ANAHEIM
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State | CA
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Zip | 92804-6446
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Country | US
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Telephone | 714-867-6594
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Fax | 714-486-1120
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Provider Business Mailing Address
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Address Line | 5802 ABRAHAM AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-2806
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Country | US
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Telephone | 714-791-4539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | NPF95027036
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License Number State | CA
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