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General NPI Number Information
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NPI Number | 1265728570
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Entity Type | Individual
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Provider Name | HESPER PHAM O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 27871 MEDICAL CENTER RD STE 120
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6405
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Country | US
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Telephone | 949-364-6688
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Fax | 949-368-6689
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Provider Business Mailing Address
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Address Line | 9061 BOLSA AVE STE 105
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City | WESTMINSTER
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State | CA
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Zip | 92683-5558
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Country | US
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Telephone | 714-899-5670
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 15212
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License Number State | CA
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