Provider Demographics
NPI:1437462264
Name:PHAM, SEAN TUNGHUY (PT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:TUNGHUY
Last Name:PHAM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8341 WESTMINSTER BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8337
Mailing Address - Country:US
Mailing Address - Phone:714-891-2739
Mailing Address - Fax:714-891-2747
Practice Address - Street 1:8341 WESTMINSTER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-8337
Practice Address - Country:US
Practice Address - Phone:714-891-2739
Practice Address - Fax:714-891-2747
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist