Individual
DR. VICTOR NGUYEN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
Mailing address
3655 W ANTHEM WAY STE A109, ANTHEM, AZ 85086-0430
(623) 879-5288
(623) 879-1563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125-057211
IL
207R00000X
Internal Medicine Physician
MD157726
OR
208M00000X
Hospitalist Physician
Primary
58475
AZ
208M00000X
Hospitalist Physician
MD157726
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500647926
—
OR
01
—
58475
AZ LICENSE
AZ
01
—
P01701362
RR MEDICARE - PH&S - OREGON (PMG)
OR
Enumeration date
07/02/2009
Last updated
07/11/2019
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