Individual
KIMBERLY THANH PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9059 W LAKE PLEASANT PKWY STE E540, PEORIA, AZ 85382-8396
(623) 322-3380
Mailing address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
69648
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
10/30/2023
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