Provider Demographics
NPI:1427924562
Name:PHAM, HUY TAN
Entity type:Individual
Prefix:
First Name:HUY
Middle Name:TAN
Last Name:PHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 AUBURN BLVD STE 162
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-0359
Mailing Address - Country:US
Mailing Address - Phone:916-202-8243
Mailing Address - Fax:916-441-6377
Practice Address - Street 1:8421 AUBURN BLVD STE 162
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-0359
Practice Address - Country:US
Practice Address - Phone:916-202-8243
Practice Address - Fax:916-441-6377
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion