| Doctor Name: | MISS LOAN VU MINH PHAM |
| NPI Number: | 1053440065 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | 1709 |
| Business Practice Address: | 921 Pacific Coast Hwy Seal Beach, CA - 907406244 |
| Business Phone Number: | 9166714612 |
| Business Fax Number: | |
| Mailing Address: | 17174 Santa Barbara St, FOUNTAIN VALLEY |
| State: | CA |
| Postal Code: | 92708 |
| Phone Number: | 9166714612 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 06/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SC1501X |
| License Number: | 1709 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Community Health/Public Health |
| Taxonomy Definition: | |