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NPI Code Detail

MEDICARE: HEATHER PHAM

MEDICARE: HEATHER 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
1225X00000XOccupational Therapist3220CA

General Provider Information

NPI Number : 1396134607
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER PHAM
Provider Business Mailing Address
First Line : 3850 E ESTHER ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3850 E ESTHER ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2009
Country : US
Telephone Number : 562-498-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2015
Last Update Date : 01/12/2015

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1194399824 — MARLA LADIKOS MA, CCC-SLP
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Directions to “ HEATHER PHAM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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