Provider Demographics
NPI:1053042986
Name:PHAM, ELIZABETH THIEN NHU (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:THIEN NHU
Last Name:PHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12608 WALCROFT ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-1912
Mailing Address - Country:US
Mailing Address - Phone:562-334-7168
Mailing Address - Fax:
Practice Address - Street 1:1760 TERMINO AVE STE 223
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2182
Practice Address - Country:US
Practice Address - Phone:562-479-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily