Provider Demographics
NPI:1245013309
Name:PHAM, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 S GIBSON RD APT 624
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2434
Mailing Address - Country:US
Mailing Address - Phone:916-878-0709
Mailing Address - Fax:
Practice Address - Street 1:80 S GIBSON RD APT 624
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2434
Practice Address - Country:US
Practice Address - Phone:916-878-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program