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General NPI Number Information
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NPI Number | 1164389383
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Entity Type | Organization
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Legal Business Name | TIFFANY PHAM MD, PC
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 11199 SORRENTO VALLEY RD STE 202
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City | SAN DIEGO
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State | CA
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Zip | 92121
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Country | US
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Telephone | 858-282-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 302 WASHINGTON ST #150-1073
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY PHAM
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Credential | MD
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Telephone | 858-282-0212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State |
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