Provider Demographics
NPI:1730644527
Name:PHAM, EMILY (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:26661 SOTELO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3300
Mailing Address - Country:US
Mailing Address - Phone:949-861-0090
Mailing Address - Fax:
Practice Address - Street 1:23141 MOULTON PKWY STE 102
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1241
Practice Address - Country:US
Practice Address - Phone:949-916-9100
Practice Address - Fax:949-916-0091
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-10-31
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant