Individual
KENNY HOA PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
292 LOS ALTOS PKWY, SPARKS, NV 89436
(775) 354-0104
Mailing address
16286 RAINIER ST., FOUNTAIN VALLEY, CA 92708
(714) 548-7255
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17592
NV
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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