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General NPI Number Information
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NPI Number | 1861670291
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Entity Type | Organization
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Legal Business Name | HANNAH PHAM OD INC
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 748 S HARBOR BLVD
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City | SANTA ANA
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State | CA
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Zip | 92704-2337
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Country | US
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Telephone | 714-839-7534
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Fax | 714-839-9635
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Provider Business Mailing Address
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Address Line | 748 S HARBOR BLVD
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City | SANTA ANA
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State | CA
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Zip | 92704-2337
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Country | US
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Telephone | 714-839-7534
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Fax | 714-839-9635
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Authorized Official
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Title or Position | OWNER
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Name | HANNAH NGOC-HA PHAM
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Credential | O.D.
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Telephone | 714-839-7534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12411T
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License Number State | CA
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