Provider Demographics
NPI:1275750861
Name:PHAM, ANH HONG (DO)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:HONG
Last Name:PHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ANH TINA
Other - Middle Name:HONG
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:8502 LAMAR DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5032
Mailing Address - Country:US
Mailing Address - Phone:714-496-9523
Mailing Address - Fax:
Practice Address - Street 1:16415 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5035
Practice Address - Country:US
Practice Address - Phone:562-602-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine