# PETER PHAM NURSING CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black Onyx, Peter Pham Nursing Corporation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750082780
- **Authorized official:** PETER PHAM NP (MR)
- **Authorized official phone:** (714) 410-6588

## Contact information

- **Practice address:** 1100 W TOWN AND COUNTRY RD STE 1239, ORANGE, CA 92868-4600
- **Practice address phone:** (714) 880-2791
- **Practice address fax:** (949) 229-0854
- **Mailing address:** 1100 W TOWN AND COUNTRY RD STE 1239, ORANGE, CA 92868-4600
- **Mailing address phone:** (714) 880-2791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2023
- **Last updated:** 11/17/2023