Provider Demographics
NPI:1457761330
Name:PHAM, BIANCA THANHBINH
Entity Type:Individual
Prefix:MS
First Name:BIANCA
Middle Name:THANHBINH
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 1:35149 NEWARK BLVD
Mailing Address - Street 2:SUITE#B
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1209
Mailing Address - Country:US
Mailing Address - Phone:510-796-4732
Mailing Address - Fax:510-796-4777
Practice Address - Street 1:35149 NEWARK BLVD
Practice Address - Street 2:SUITE#B
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1209
Practice Address - Country:US
Practice Address - Phone:510-796-4732
Practice Address - Fax:510-796-4777
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician