Individual
AN N PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 DELBON AVE, TURLOCK, CA 95382-2016
(209) 667-4200
(209) 669-2377
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A36776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A367760
BS OF CA
CA
05
—
00A367760
—
CA
Enumeration date
05/22/2006
Last updated
01/08/2008
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