Provider Demographics
NPI:1376942631
Name:PHAM, HONG MY I
Entity type:Individual
Prefix:MRS
First Name:HONG
Middle Name:MY
Last Name:PHAM
Suffix:I
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 1:4856 S BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5948
Mailing Address - Country:US
Mailing Address - Phone:626-689-9997
Mailing Address - Fax:
Practice Address - Street 1:1537 ALTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1712
Practice Address - Country:US
Practice Address - Phone:303-923-2920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO003858A4AM2AOtherMEDICAL/RX CARD