Provider Demographics
NPI:1457805137
Name:PHAM, ALEXANDER HUY (OD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:HUY
Last Name:PHAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 SAN CLEMENTE AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-4311
Mailing Address - Country:US
Mailing Address - Phone:626-274-7052
Mailing Address - Fax:
Practice Address - Street 1:EYE CARUMBA OPTOMETRY
Practice Address - Street 2:FOUR EMBARCADERO CENTER, LL3
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111
Practice Address - Country:US
Practice Address - Phone:415-772-8282
Practice Address - Fax:415-772-8222
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33563152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist