Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | AC6249 | CA |
N | 213ES0000X | Sports Medicine | AC6249 | CA |
NPI | 1467692871 |
---|---|
Provider Name | Kim Nguyen N Pham |
First Address | Westminster, CA 92683-7425 |
Second Address | Westminster, CA 92683-7425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2009 |
Last Update Date | 25/02/2009 |