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NPI Code Detail

MEDICARE: DR. ANTHONY PHAM M.D.

MEDICARE: DR. ANTHONY PHAM M.D.
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
1207R00000XInternal Medicine PhysicianLP01695RI
2207RH0003XHematology & Oncology Physician57041MN
3207RH0003XHematology & Oncology PhysicianMD176450OR

General Provider Information

NPI Number : 1790913994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY PHAM M.D.
Provider Business Mailing Address
First Line : 1498 SE TECH CENTER PL STE 240
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-5508
Country : US
Telephone Number : 360-597-1313
Fax Number :
Provider Business Practice Location Address
First Line : 12123 SW 69TH AVE
Second Line :
City : TIGARD
State : OR
Zip : 97223-8514
Country : US
Telephone Number : 971-708-7600
Fax Number : 971-371-5230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 05/16/2024

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