Individual
CHRISTINE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10039 VINE ST, LAKESIDE, CA 92040-3120
(619) 390-9975
Mailing address
10039 VINE ST, LAKESIDE, CA 92040-3120
(619) 390-9975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A16800
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
08/12/2020
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