Individual
THANH TRUNG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
590 N SIERRA WAY, SAN BERNARDINO, CA 92410-4817
(909) 495-3595
(909) 763-2544
Mailing address
590 N SIERRA WAY, SAN BERNARDINO, CA 92410-4817
(909) 495-3595
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA59381
CA
Other
Enumeration date
08/30/2020
Last updated
08/16/2022
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