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General NPI Number Information
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NPI Number | 1952403396
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Entity Type | Individual
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Provider Name | DAVID P PHAM D.O
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 308 W 6TH ST STE 101
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City | CORONA
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State | CA
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Zip | 92882-3349
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Country | US
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Telephone | 951-737-0910
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Fax | 951-371-1906
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Provider Business Mailing Address
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Address Line | 1901 TOWN AND COUNTRY DR STE 104
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City | NORCO
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State | CA
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Zip | 92860-3611
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Country | US
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Telephone | 951-737-0910
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Fax | 951-371-1906
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A7848
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License Number State | CA
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