Individual
KEVIN GUNNEY PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
620 SHADOW LANE, LAS VEGAS, NV 89106-4194
(702) 477-6572
(702) 388-8431
Mailing address
620 SHADOW LANE, LAS VEGAS, NV 89106-4194
(702) 477-6572
(702) 388-8431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO1944
NV
207R00000X
Internal Medicine Physician
SL0902
NV
208M00000X
Hospitalist Physician
Primary
20A14043
CA
Other
Enumeration date
06/20/2012
Last updated
04/11/2018
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