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Individual

MANH DUC PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7551 MADISON AVE, CITRUS HEIGHTS, CA 95610-7449
(916) 904-3000
(916) 863-2962
Mailing address
7551 MADISON AVENUE, CITRUS HEIGHTS, CA 95610
(916) 904-3000
(916) 863-2962

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
122553
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003139257A
GA
Enumeration date
06/22/2010
Last updated
08/19/2014
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