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NPI Code Detail

MEDICARE: LEANN NGO PHAM

MEDICARE: LEANN NGO 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
1183500000XPharmacist58059CA

General Provider Information

NPI Number : 1891963062
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANN NGO PHAM
Provider Business Mailing Address
First Line : 1900 E 4TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3962
Country : US
Telephone Number : 866-353-5060
Fax Number :
Provider Business Practice Location Address
First Line : 1900 E 4TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3962
Country : US
Telephone Number : 866-353-5060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2008
Last Update Date : 02/01/2017

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Directions to “ LEANN NGO PHAM ” Practice Location

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