Individual
BAO PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11818 WILSHIRE BLVD STE 200, LOS ANGELES, CA 90025-6647
(310) 231-2105
Mailing address
11818 WILSHIRE BLVD STE 200, LOS ANGELES, CA 90025-6647
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
68114
CA
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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