Organization
HUNG DO PHAM
Active
Other names
SAN JOSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LOAN TU NGUYEN PHAM (PIC)
(408) 280-0797
Entity
Organization
Contact information
Practice address
567 E SANTA CLARA ST, SAN JOSE, CA 95112-2014
(408) 280-0797
(408) 280-0798
Mailing address
567 E SANTA CLARA ST, SAN JOSE, CA 95112-2014
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY40015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0549901
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA400150
—
CA
Enumeration date
04/19/2007
Last updated
05/12/2009
Update your record
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