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Individual

TIMOTHY PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1879 LUNDY AVE # 122, SAN JOSE, CA 95131-1834
(408) 433-3930
(408) 433-3931
Mailing address
1879 LUNDY AVE # 122, SAN JOSE, CA 95131-1834
(408) 433-3930
(408) 433-3931

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000E39370
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E39370
CA
Enumeration date
07/13/2006
Last updated
12/08/2007
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