Provider Demographics
NPI:1427136308
Name:PHAM, ANH B (PHARMD)
Entity type:Individual
Prefix:
First Name:ANH
Middle Name:B
Last Name:PHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25975 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3416
Mailing Address - Country:US
Mailing Address - Phone:310-517-3509
Mailing Address - Fax:310-517-4176
Practice Address - Street 1:25975 NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3416
Practice Address - Country:US
Practice Address - Phone:310-517-3509
Practice Address - Fax:310-517-4176
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist