Organization
BOLSA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CO D C PHAM MD (PRESIDENT)
(714) 531-2091
Entity
Organization
Contact information
Practice address
10362 BOLSA AVE, WESTMINSTER, CA 92683-6763
(714) 531-2091
(714) 531-1403
Mailing address
10362 BOLSA AVE, WESTMINSTER, CA 92683-6763
(714) 531-2091
(714) 531-1403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0061390
—
CA
Enumeration date
06/26/2006
Last updated
09/11/2025
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