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General NPI Number Information
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NPI Number | 1497967541
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Entity Type | Organization
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Legal Business Name | ANNIE PHAM-CHENG, DMD, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6134 CALLE REAL, STE B
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City | GOLETA
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State | CA
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Zip | 93117
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Country | US
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Telephone | 805-681-7301
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Fax | 805-681-7302
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Provider Business Mailing Address
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Address Line | 6134 CALLE REAL, STE B
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City | GOLETA
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State | CA
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Zip | 93117
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Country | US
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Telephone | 805-681-7301
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Fax | 805-681-7302
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Authorized Official
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Title or Position | CEO
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Name | DR. ANNIE PHAM-CHENG
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Credential | D.M.D.
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Telephone | 805-681-7301
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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 | 53348
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License Number State | CA
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