Individual
PHIVAN PHAM-CCASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S SAN VICENTE BLVD, LOS ANGELES, CA 90048-4653
(310) 873-3312
Mailing address
9912 CHESHIRE AVE, WESTMINSTER, CA 92683-5708
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95038118
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
NP95038118
CA
Other
Enumeration date
01/16/2026
Last updated
04/06/2026
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