Provider Demographics
NPI:1396776977
Name:PHAM, NHU Q (MD)
Entity type:Individual
Prefix:DR
First Name:NHU
Middle Name:Q
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1450 TREAT BLVD
Mailing Address - Street 2:# 300
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:
Practice Address - Street 1:1505 SAINT ALPHONSUS WAY
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1570
Practice Address - Country:US
Practice Address - Phone:925-838-5750
Practice Address - Fax:925-838-5769
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA79163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A791630Medicaid
CAG96156Medicare UPIN
CA00A791630Medicaid