MEDICARE: DR. DAVID P PHAM D.O

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	207P00000X	Emergency Medicine Physician	20A7848	CA

General Provider Information

NPI Number	:	1952403396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P PHAM D.O

Provider Business Mailing Address
First Line	:	1901 TOWN AND COUNTRY DR STE 104
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-3611
Country	:	US
Telephone Number	:	951-737-0910
Fax Number	:	951-371-1906

Provider Business Practice Location Address
First Line	:	308 W 6TH ST STE 101
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92882-3349
Country	:	US
Telephone Number	:	951-737-0910
Fax Number	:	951-371-1906

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	05/21/2024

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Directions to “ DR. DAVID P PHAM D.O” Practice Location

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