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General NPI Number Information
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NPI Number | 1629436514
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Entity Type | Organization
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Legal Business Name | KRYSTAL PHAM OB GYN INC
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 11160 WARNER AVE STE 219
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4048
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Country | US
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Telephone | 714-486-1228
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Fax | 714-486-3108
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Provider Business Mailing Address
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Address Line | 11160 WARNER AVE STE 219
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4048
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Country | US
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Telephone | 714-486-1228
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Fax | 714-486-3108
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRYSTAL HANHTRAN PHAM
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Credential | M.D.
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Telephone | 702-335-5421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A114075
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License Number State | CA
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