Provider Demographics
NPI:1770560138
Name:PHAM, HUAN (MD)
Entity type:Individual
Prefix:DR
First Name:HUAN
Middle Name:
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2718 U ST
Mailing Address - Street 2:#1
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1965
Mailing Address - Country:US
Mailing Address - Phone:408-227-9980
Mailing Address - Fax:916-734-6548
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:#3100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-5195
Practice Address - Fax:916-734-6548
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2021-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA895092471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN