Individual
DR. QUOCBAO PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
16407
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16407
PHARMACY LICENSE
MD
01
—
P-500-723-015-866
DRIVER'S LICENSE
MD
Enumeration date
02/28/2007
Last updated
07/08/2007
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