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Organization
HAI PHAM D.D.S, INC
Active
Organization
HAI PHAM D.D.S, INC
Active
Other names
HP Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAI TAN PHAM DDS (PRESIDENT)
(510) 836-4755
Entity
Organization
Contact information
Practice address
650 INTERNATIONAL BLVD STE A, OAKLAND, CA 94606-2987
(510) 836-4755
(510) 836-4715
Mailing address
650 INTERNATIONAL BLVD STE A, OAKLAND, CA 94606-2987
(510) 836-4755
(510) 836-4715
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
41031
CA
122300000X
Dentist
43264
CA
122300000X
Dentist
59463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56459
CALIFORNIA DENTAL LICENSE #
CA
01
—
63719
CA LICENSE #
CA
01
—
B41031
DENTI-CAL
CA
01
—
B59463
DENTI-CAL
CA
01
—
D43264
DENTI-CAL
CA
Enumeration date
01/18/2012
Last updated
03/08/2022
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