Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A71816 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A71816 | CA |
NPI | 1194735019 |
---|---|
Provider Name | Dr. Michael X Pham |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Francisco, CA 94109-6920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 20/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HSP40441H | (05) | CA |
I34047 | (02) | CA |