Provider Demographics
NPI:1942251905
Name:PHAM, TUAN ANH (DPT)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:ANH
Last Name:PHAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 WESTMINSTER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2751
Mailing Address - Country:US
Mailing Address - Phone:714-705-5372
Mailing Address - Fax:714-530-7760
Practice Address - Street 1:9191 WESTMINSTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2751
Practice Address - Country:US
Practice Address - Phone:714-705-5372
Practice Address - Fax:714-530-7760
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist