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General NPI Number Information
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NPI Number | 1356899082
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Entity Type | Individual
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Provider Name | AN PHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/11/2016
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1000 E BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23219-1930
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Country | US
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Telephone | 804-628-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 9291 KREPP DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2705
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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 |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 60764804
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 144305
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 60764804
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 0101272792
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License Number State | VA
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