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NPI Code Detail

MEDICARE: BRYAN TRUNG PHAM

MEDICARE: BRYAN TRUNG 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
1183500000XPharmacist70261CA

General Provider Information

NPI Number : 1437576006
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN TRUNG PHAM
Provider Business Mailing Address
First Line : 78218 VARNER RD
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-4134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 78218 VARNER RD
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-4134
Country : US
Telephone Number : 760-200-4382
Fax Number : 760-772-0290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2014
Last Update Date : 08/12/2022

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Directions to “ BRYAN TRUNG PHAM ” Practice Location

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