Individual
DR. ANTHONY TAI QUANG PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4240 KEARNY MESA RD., SUITE #117, SAN DIEGO, CA 92111
(858) 499-8911
(858) 499-8913
Mailing address
4240 KEARNY MESA RD., SUITE #117, SAN DIEGO, CA 92111
(858) 499-8911
(858) 499-8913
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
986142
UNITED CONCORDIA
CA
01
—
B41665-01
HEALTHY FAMILIES PROGRAM
CA
01
—
G92731-01
DENTI-CAL
CA
01
—
ZDT727
BLUE CROSS OF MA
CA
Enumeration date
10/02/2006
Last updated
07/08/2007
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