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Organization
TONY D PHAM OD INC
Active
Organization
TONY D PHAM OD INC
Active
Other names
MIRA MESA EYECARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY DIEU PHAM O.D. (PRESIDENT/CEO)
(858) 535-8282
Entity
Organization
Contact information
Practice address
6755 MIRA MESA BLVD., SUITE 141, SAN DIEGO, CA 92121-4311
(916) 483-6661
(916) 483-6664
Mailing address
6755 MIRA MESA BLVD, SUITE 141, SAN DIEGO, CA 92121-4392
(858) 535-8282
(858) 535-0537
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12348
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760672315
—
CA
Enumeration date
07/30/2007
Last updated
05/12/2009
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