Organization
KEVIN PHAM, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PHAM M.D. (PRESIDENT)
(714) 836-4204
Entity
Organization
Contact information
Practice address
500 S MAIN ST STE 101, ORANGE, CA 92868-4535
(714) 836-4204
(714) 836-1809
Mailing address
500 S MAIN ST STE 101, ORANGE, CA 92868-4535
(714) 836-4204
(714) 836-1809
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A67209
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A672090
MEDICAL
CA
Enumeration date
01/30/2008
Last updated
01/30/2008
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