Provider Demographics
NPI:1477354090
Name:PHAM, LILLIAN (DACCHM, LAC)
Entity type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:
Last Name:PHAM
Suffix:
Gender:
Credentials:DACCHM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6432 SETTING SUN DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6715
Mailing Address - Country:US
Mailing Address - Phone:714-837-9754
Mailing Address - Fax:
Practice Address - Street 1:3030 SAWTELLE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-1408
Practice Address - Country:US
Practice Address - Phone:310-390-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC20261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist