Provider Demographics
NPI:1487085056
Name:PHAM, BINH T (RPH)
Entity type:Individual
Prefix:
First Name:BINH
Middle Name:T
Last Name:PHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 STABLER LN
Mailing Address - Street 2:APT 22
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-2058
Mailing Address - Country:US
Mailing Address - Phone:510-342-6418
Mailing Address - Fax:
Practice Address - Street 1:1450 STABLER LANE
Practice Address - Street 2:APT 22
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2028
Practice Address - Country:US
Practice Address - Phone:510-342-6418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist