Individual
HUYEN QUANG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1441 EASTLAKE AVE, LOS ANGELES, CA 90089-9171
(323) 865-0062
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 221-3270
(323) 225-6284
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
A70006
CA
207VX0201X
Gynecologic Oncology Physician
Primary
A70006
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A700060
—
CA
01
—
ZZZ20990Z
BLUE SHIELD
CA
Enumeration date
06/20/2006
Last updated
09/15/2018
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