MEDICARE: CINDY PHAM PA-C

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	363AS0400X	Surgical Physician Assistant	0110011240	VA

General Provider Information

NPI Number	:	1528619640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY PHAM PA-C

Provider Business Mailing Address
First Line	:	7601 LEWINSVILLE RD STE 400
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-2834
Country	:	US
Telephone Number	:	703-287-8277
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 LEWINSVILLE RD STE 400
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-2834
Country	:	US
Telephone Number	:	703-287-8277
Fax Number	:	703-287-8278

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

Provider Enumeration Date	:	09/20/2019
Last Update Date	:	11/20/2025

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Directions to “ CINDY PHAM PA-C” Practice Location

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