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General NPI Number Information
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NPI Number | 1689164642
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Entity Type | Individual
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Provider Name | CHARLEEN PHAM D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3440 E LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92806-2020
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 9651 GISLER DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7507
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Country | US
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Telephone | 714-837-0214
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A22234
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License Number State | CA
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