Organization
CALIFORNIA EMERGENCY PHYSICIAN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM YEN PHAM PA-C (MID LEVEL PRACTITIONER)
(323) 727-0205
Entity
Organization
Contact information
Practice address
615 W LINCOLN AVE, MONTEBELLO, CA 90640-3528
(323) 727-0205
Mailing address
615 W LINCOLN AVE, MONTEBELLO, CA 90640-3528
(323) 727-0205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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