Individual
VICKY PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12351 PENTAGON ST, GARDEN GROVE, CA 92841-3326
(714) 383-4670
Mailing address
4152 KATELLA AVE STE 201, LOS ALAMITOS, CA 90720-6608
(562) 598-0600
(562) 598-0678
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95021273
CA
Other
Enumeration date
06/20/2022
Last updated
08/19/2022
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