Provider Demographics
NPI:1851806947
Name:PHAM, AN HONG (RPH)
Entity Type:Individual
Prefix:DR
First Name:AN
Middle Name:HONG
Last Name:PHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 MELINDA CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-8427
Mailing Address - Country:US
Mailing Address - Phone:714-837-4466
Mailing Address - Fax:
Practice Address - Street 1:10011 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-4904
Practice Address - Country:US
Practice Address - Phone:714-963-8391
Practice Address - Fax:714-963-8964
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist