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Organization
PETER PHAM NURSING CORPORATION
Active
Organization
PETER PHAM NURSING CORPORATION
Active
Other names
Black Onyx, Peter Pham Nursing Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
PETER PHAM NP (MR)
(714) 410-6588
Entity
Organization
Contact information
Practice address
1100 W TOWN AND COUNTRY RD STE 1239, ORANGE, CA 92868-4600
(714) 880-2791
(949) 229-0854
Mailing address
1100 W TOWN AND COUNTRY RD STE 1239, ORANGE, CA 92868-4600
(714) 880-2791
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
11/17/2023
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