Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 20A17125 | CA |
NPI | 1073907044 |
---|---|
Provider Name | Maggie Pham |
First Address | Pomona, CA 91767-2922 |
Second Address | Pomona, CA 91767-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 05/08/2021 |