Provider Demographics
NPI:1639261951
Name:PHAM, SHERI AIHUONG (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:AIHUONG
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 W COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2010
Mailing Address - Country:US
Mailing Address - Phone:626-914-5553
Mailing Address - Fax:626-967-3849
Practice Address - Street 1:158 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723
Practice Address - Country:US
Practice Address - Phone:626-331-0175
Practice Address - Fax:626-967-3849
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69662207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA69662AMedicare ID - Type Unspecified
I04419Medicare UPIN