Provider Demographics
NPI:1346551819
Name:PHAM, HOANG H (MD)
Entity Type:Individual
Prefix:DR
First Name:HOANG
Middle Name:H
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1425
Mailing Address - Country:US
Mailing Address - Phone:408-885-5611
Mailing Address - Fax:408-885-3048
Practice Address - Street 1:2105 FOREST AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1425
Practice Address - Country:US
Practice Address - Phone:408-885-5611
Practice Address - Fax:408-885-3048
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA120294208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist