Provider Demographics
NPI:1265728570
Name:PHAM, HESPER (OD)
Entity type:Individual
Prefix:DR
First Name:HESPER
Middle Name:
Last Name:PHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9061 BOLSA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5558
Mailing Address - Country:US
Mailing Address - Phone:714-899-5670
Mailing Address - Fax:
Practice Address - Street 1:27871 MEDICAL CENTER RD STE 120
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6405
Practice Address - Country:US
Practice Address - Phone:949-364-6688
Practice Address - Fax:949-368-6689
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15212152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist