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Organization
TAM NGUYEN THI PHAM MD INC
Active
Organization
TAM NGUYEN THI PHAM MD INC
Active
Other names
Lighthouse Anesthesia Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
TAM NGUYEN THI PHAM (PRESIDENT)
(714) 636-0342
Entity
Organization
Contact information
Practice address
12900A GARDEN GROVE BLVD, STE 122, GARDEN GROVE, CA 92843
(714) 636-0342
(714) 636-0391
Mailing address
PO BOX 775, GARDEN GROVE, CA 92842
(714) 636-0342
(714) 636-0391
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G81625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G816250
—
CA
01
—
P00205661
RAILROAD MEDICARE
CA
Enumeration date
11/28/2006
Last updated
06/27/2008
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