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General NPI Number Information
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NPI Number | 1528619640
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Entity Type | Individual
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Provider Name | CINDY PHAM PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 7601 LEWINSVILLE RD STE 400
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City | MC LEAN
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State | VA
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Zip | 22102-2834
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Country | US
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Telephone | 703-287-8277
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Fax | 703-287-8278
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Provider Business Mailing Address
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Address Line | 7601 LEWINSVILLE RD STE 400
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City | MC LEAN
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State | VA
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Zip | 22102-2834
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Country | US
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Telephone | 703-287-8277
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0110011240
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License Number State | VA
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