Individual
ANN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-2035
Mailing address
2485 NEWGROVE PL, ESCONDIDO, CA 92027-1777
(442) 222-9734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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