Provider Demographics
NPI:1558006338
Name:PHAM, HOANG MINH (DO)
Entity Type:Individual
Prefix:
First Name:HOANG
Middle Name:MINH
Last Name:PHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11862 NEARING DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6750
Mailing Address - Country:US
Mailing Address - Phone:714-487-7495
Mailing Address - Fax:
Practice Address - Street 1:1770 N ORANGE GROVE AVE STE 101
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3027
Practice Address - Country:US
Practice Address - Phone:909-469-9494
Practice Address - Fax:909-469-2120
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program