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General NPI Number Information
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NPI Number | 1811412687
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Entity Type | Organization
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Legal Business Name | PHAM ACUPUNCTURE PROFESSIONAL CORPORATTION
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 3760 STATE ST STE 102
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3181
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Country | US
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Telephone | 805-563-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 895 FORTUNA LN
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City | GOLETA
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State | CA
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Zip | 93117-4316
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Country | US
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Telephone | 805-300-7465
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. TRAM PHAM
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Credential | ACUPUNCTURIST
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Telephone | 805-300-7465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 16361
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License Number State | CA
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