Provider Demographics
NPI:1255471116
Name:THUY-KHANH PHAM CHIROPRACTIC INC
Entity Type:Organization
Organization Name:THUY-KHANH PHAM CHIROPRACTIC INC
Other - Org Name:KP CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY-KHANH
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-262-1029
Mailing Address - Street 1:1683 N MILPITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-2721
Mailing Address - Country:US
Mailing Address - Phone:408-262-1029
Mailing Address - Fax:
Practice Address - Street 1:1683 N MILPITAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-2721
Practice Address - Country:US
Practice Address - Phone:408-262-1029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 25609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty