Provider Demographics
NPI:1003888603
Name:PHAM, CHRISTOPHER DE (DC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DE
Last Name:PHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:HUNG
Other - Middle Name:MANH
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 SARATOGA AVE
Mailing Address - Street 2:#205
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051
Mailing Address - Country:US
Mailing Address - Phone:408-260-8292
Mailing Address - Fax:408-260-0639
Practice Address - Street 1:85 SARATOGA AVE
Practice Address - Street 2:#205
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051
Practice Address - Country:US
Practice Address - Phone:408-260-8292
Practice Address - Fax:408-260-0639
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor