Provider Demographics
NPI:1750639993
Name:PHAM, JOHN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 742502
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2502
Mailing Address - Country:US
Mailing Address - Phone:408-885-5000
Mailing Address - Fax:408-283-7646
Practice Address - Street 1:143 N MAIN ST, 2ND FL
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035
Practice Address - Country:US
Practice Address - Phone:408-957-8300
Practice Address - Fax:408-946-8442
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2015-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA123403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine