Individual
JONATHAN THEODORE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C', LOMA LINDA, CA 92354-2804
(909) 558-4074
Mailing address
11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C', LOMA LINDA, CA 92354-2804
(909) 558-4074
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A176996
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL2502322
LOMA LINDA UNIVERSITY RISK MANAGEMENT
—
Enumeration date
05/08/2019
Last updated
10/05/2022
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