Individual
DR. SALLY THANH PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
48 FENTON ST, LIVERMORE, CA 94550-4144
(925) 455-1555
(925) 292-7592
Mailing address
48 FENTON ST, LIVERMORE, CA 94550-4144
(925) 455-1555
(925) 292-7592
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4685
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6337710001
NSC PTAN
CA
Enumeration date
03/05/2007
Last updated
12/15/2021
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