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NPI Code Detail

MEDICARE: DIEM QUYNH PHAM D.O.

MEDICARE:   DIEM QUYNH PHAM  D.O.
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
1207NS0135XProcedural Dermatology Physician20A7309CA

General Provider Information

NPI Number : 1255421335
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEM QUYNH PHAM D.O.
Provider Business Mailing Address
First Line : 3110 CHINO AVE STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1294
Country : US
Telephone Number : 909-313-5111
Fax Number : 909-313-0959
Provider Business Practice Location Address
First Line : 3110 CHINO AVE STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1294
Country : US
Telephone Number : 909-313-5111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 05/13/2026

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Directions to “ DIEM QUYNH PHAM D.O.” Practice Location

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