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General NPI Number Information
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NPI Number | 1578852448
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Entity Type | Organization
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Legal Business Name | ANH TU PHAM D.D.S., INC.
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 8244 EAST GARVEY AVE SUITE A
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City | ROSEMEAD
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State | CA
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Zip | 91770
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Country | US
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Telephone | 626-288-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 8244 EAST GARVEY AVE SUITE A
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City | ROSEMEAD
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State | CA
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Zip | 91770
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Country | US
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Telephone | 626-288-9797
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANH TU PHAM
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Credential |
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Telephone | 626-288-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51371
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License Number State | CA
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