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1573 S Harbor Blvd Fullerton CA 92832-3402 | |
| (714) 441-0131 | |
| (714) 441-0141 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1573 S Harbor Blvd, Fullerton, California |
| Authorized Official Name and Position | Peter H Pham (OWNER) |
| Authorized Official Contact | 7144410131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | 1573 S Harbor Blvd Fullerton CA 92832-3402 Ph: (714) 441-0131 |
| NPI Number | 1114364395 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 05/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114364395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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