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Individual

DR. HEIDI Q.T. PHAM

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
O,D,

Contact information

Practice address
1869 ARDEN FAIR MALL,, SUITE 1091, SACRAMENTO, CA 95815
(916) 929-5909
(916) 929-8202
Mailing address
8684 MARIALAINA CT, SACRAMENTO, CA 95828-5063
(916) 929-5909
(916) 929-8202

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11521T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SD011521
CA
Enumeration date
12/23/2005
Last updated
07/09/2007
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