| Jefferey Pham Dental Corp | |
|
7812 Warner Ave Huntington Beach CA 92647-4700 | |
| (714) 375-3222 | |
| (714) 375-3223 |
| Full Name | Jefferey Pham Dental Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 7812 Warner Ave, Huntington Beach, California |
| Authorized Official Name and Position | Jefferey Pham (CEO) |
| Authorized Official Contact | 7148230854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferey Pham Dental Corp 15701 Spar St Garden Grove CA 92843-5353 Ph: (714) 823-0854 | Jefferey Pham Dental Corp 7812 Warner Ave Huntington Beach CA 92647-4700 Ph: (714) 375-3222 |
| NPI Number | 1144748344 |
|---|---|
| Provider Enumeration Date | 09/07/2017 |
| Last Update Date | 09/07/2017 |
| Medicare PECOS PAC ID | 4284978784 |
|---|---|
| Medicare Enrollment ID | O20181211001887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144748344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 63830 (California) | Primary |
| Provider Name | Jefferey Pham |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033510771 PECOS PAC ID: 9638478381 Enrollment ID: I20190506000237 |
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