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NPI Code Detail

MEDICARE: DR. KRYSTAL HONG-QUYEN PHAM D.D.S.

MEDICARE:  DR. KRYSTAL HONG-QUYEN PHAM  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry57473CA

General Provider Information

NPI Number : 1124277736
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRYSTAL HONG-QUYEN PHAM D.D.S.
Provider Business Mailing Address
First Line : 16052 BEACH BLVD
Second Line : STE 112
City : HUNTINGTON BEACH
State : CA
Zip : 92647-3801
Country : US
Telephone Number : 714-841-0203
Fax Number :
Provider Business Practice Location Address
First Line : 16052 BEACH BLVD STE 112
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-3842
Country : US
Telephone Number : 714-841-0203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 08/12/2014

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Directions to “ DR. KRYSTAL HONG-QUYEN PHAM D.D.S.” Practice Location

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