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BANG VU PHAM M D PROFESSIONAL NPI 1447262522


NPI Information

NPI: 1447262522
Provider Name: BANG VU PHAM M D PROFESSIONAL

Doing Business As: ST.PAUL MEDICAL CENTER OF THE S. BAY

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0693906

Address:
12923 INGLEWOOD AVE STE 1
HAWTHORNE, CA
ZIP 90250
Phone: (310) 675-0395
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BANG VU PHAM M D PROFESSIONAL is a family medicine in Hawthorne, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BANG VU PHAM M D PROFESSIONAL NPI is 1447262522. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As St.paul Medical Center Of The S. Bay.

The provider's business location address is:

12923 INGLEWOOD AVE STE 1
HAWTHORNE, CA
ZIP 90250
Phone: (310) 675-0395
Fax: (310) 675-0497

The provider's authorized official is Dolly V. Pham .
The authorized official title is Vice-president-coo and has the following contact phone number (310) 675-0395.

The CLIA number assigned to this NPI record is 05D0693906 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/13/2006 and was last updated on 7/6/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0044320MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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