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Individual

MR. HUAN PHU PHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5252 EL CAJON BLVD APT 208, SAN DIEGO, CA 92115-4762
(619) 314-2728
Mailing address
5252 EL CAJON BLVD APT 208, SAN DIEGO, CA 92115-4762
(619) 314-2728

Taxonomy

Speciality
Code
Description
License number
State
102X00000X
Poetry Therapist
1710I1003X
Independent Duty Medical Technicians
171WH0202X
Home Modifications Contractor
174400000X
Specialist
1744R1103X
Research Study Abstracter/Coder
Primary
177F00000X
Lodging Provider
251X00000X
Supports Brokerage Agency
302F00000X
Exclusive Provider Organization
305S00000X
Point of Service
331L00000X
Blood Bank
342000000X
Transportation Network Company
344800000X
Air Carrier
347C00000X
Private Vehicle
347D00000X
Train
347E00000X
Transportation Broker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
93638370A18274
CA
Enumeration date
10/10/2022
Last updated
10/10/2022
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