Individual
DR. THOMAS TUAN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., CAQSM
Contact information
Practice address
4444 MAGNOLIA AVE, RIVERSIDE, CA 92501-4136
(949) 929-9519
(951) 274-3442
Mailing address
4444 MAGNOLIA AVE, RIVERSIDE, CA 92501-4136
(949) 929-9519
(951) 274-3442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A9023
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
20A9023
CA
Other
Enumeration date
10/02/2007
Last updated
12/01/2021
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