Individual
COREY PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3276 CASA GRANDE DR, SAN RAMON, CA 94583-3004
(916) 276-2503
Mailing address
3276 CASA GRANDE DR, SAN RAMON, CA 94583-3004
(916) 276-2503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
64877
CA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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