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General NPI Number Information
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NPI Number | 1487886594
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Entity Type | Individual
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Provider Name | TRINH T PHAM D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 2156 E LINCOLN AVE
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City | ANAHEIM
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State | CA
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Zip | 92806-4104
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Country | US
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Telephone | 714-399-3140
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Fax |
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Provider Business Mailing Address
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Address Line | 1251 S BERKLEY ST
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City | ANAHEIM
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State | CA
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Zip | 92804-4607
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Country | US
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Telephone | 714-310-0913
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 50054621
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 59266
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License Number State | CA
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