Provider Demographics
NPI:1598213597
Name:PHAM, LESLIE NHI (OD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:NHI
Last Name:PHAM
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27818 CLINTON KEITH RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8554
Mailing Address - Country:US
Mailing Address - Phone:951-566-5526
Mailing Address - Fax:951-246-3321
Practice Address - Street 1:27818 CLINTON KEITH RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8554
Practice Address - Country:US
Practice Address - Phone:951-672-3198
Practice Address - Fax:951-246-3321
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33586152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist