Individual
DR. CO DANG LONG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10362 BOLSA AVE, BOLSA MEDICAL GROUP, WESTMINSTER, CA 92683-6763
(714) 531-2091
(714) 531-1403
Mailing address
10362 BOLSA AVE, BOLSA MEDICAL GROUP, WESTMINSTER, CA 92683-6763
(714) 531-2091
(714) 531-1403
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A34091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A340910
—
CA
Enumeration date
07/05/2006
Last updated
12/12/2011
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