Provider Demographics
NPI:1447135421
Name:PHAM, PHUONG THI MINH (DC)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:THI MINH
Last Name:PHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52592
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-2592
Mailing Address - Country:US
Mailing Address - Phone:949-463-2982
Mailing Address - Fax:
Practice Address - Street 1:33 ORANGE BLOSSOM
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4418
Practice Address - Country:US
Practice Address - Phone:949-463-2982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor