Provider Demographics
NPI:1982648374
Name:PHAM, LOY ANH (MD)
Entity Type:Individual
Prefix:
First Name:LOY
Middle Name:ANH
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8500 FLORENCE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4056
Mailing Address - Country:US
Mailing Address - Phone:562-869-4579
Mailing Address - Fax:562-862-1765
Practice Address - Street 1:8500 FLORENCE AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4056
Practice Address - Country:US
Practice Address - Phone:562-869-4579
Practice Address - Fax:562-862-1765
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45904207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA45904JMedicare ID - Type Unspecified
CAF05370Medicare UPIN