Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A107882 | CA |
NPI | 1013148998 |
---|---|
Provider Name | Kim Pham |
First Address | San Jose, CA 95122 |
Second Address | San Jose, CA 95122-2902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2009 |
Last Update Date | 11/02/2022 |