Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | G86094 | CA |
NPI | 1043401698 |
---|---|
Provider Name | David N Pham |
First Address | Westminster, CA 92683-4454 |
Second Address | Westminster, CA 92683-4454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 07/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G94056 | (02) | CA |