Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 054288 | CO |
NPI | 1114154903 |
---|---|
Provider Name | Dr. Quyen Ngoc Pham |
First Address | Denver, CO 80247-1314 |
Second Address | Lafayette, CO 80026-3370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 22/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024982 | KAISER COMMERCIAL NUMBER (01) | CO |
09033017 | (05) | CO |