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Organization
MARY PHAM CHIROPRACTIC INC
Active
Organization
MARY PHAM CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PHAM (DC)
(949) 654-8219
Entity
Organization
Contact information
Practice address
14795 JEFFRY ROAD # 104, IRVINE, CA 92618
(949) 654-8219
Mailing address
14795 JEFFRY ROAD # 104, IRVINE, CA 92618
(949) 654-8219
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC22812
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619197035
BLUE CROSS / BLUE SHIELD OF ILLINOIS
CA
Enumeration date
04/26/2007
Last updated
07/07/2008
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