MEDICARE: HUAN TRI PHAM

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
1	363A00000X	Physician Assistant	PA65843	CA

General Provider Information

NPI Number	:	1366256166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUAN TRI PHAM

Provider Business Mailing Address
First Line	:	9024 BOLSA AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5531
Country	:	US
Telephone Number	:	714-899-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	9024 BOLSA AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-5531
Country	:	US
Telephone Number	:	626-573-9003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	01/07/2026

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Directions to “ HUAN TRI PHAM ” Practice Location

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