MEDICARE: SANG PHAM D.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	111N00000X	Chiropractor	01-05553	KS
2	111N00000X	Chiropractor	7078	CO
3	111N00000X	Chiropractor	4464	OK

General Provider Information

NPI Number	:	1750737938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANG PHAM D.C.

Provider Business Mailing Address
First Line	:	7324 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3246
Country	:	US
Telephone Number	:	405-242-3058
Fax Number	:

Provider Business Practice Location Address
First Line	:	7324 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3246
Country	:	US
Telephone Number	:	405-242-3058
Fax Number	:

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

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	09/05/2025

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