| Doctor Name: | CHUNG THI PHAM |
| NPI Number: | 1568504678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1680 E Hill St Signal Hill, CA - 907553612 |
| Business Phone Number: | 7143126405 |
| Business Fax Number: | |
| Mailing Address: | 323 N Euclid St, # 178 SANTA ANA |
| State: | CA |
| Postal Code: | 927033068 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 11/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |