Stacy Mai Pham is a Dentist in Riverside, California. Stacy Mai Pham practices all healthcare services and medical treatments related to Dentist. The NPI Number for Stacy Mai Pham is 1063420255. The last update date is 2020-01-27.
Stacy Mai Pham's current location address is 4000 Tyler St, Riverside, California. You can contact this provider via phone number 9516874155 and fax number 9516877448. The mailing address for Stacy Mai Pham is 4000 Tyler St, Riverside, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacy Mai Pham |
|---|---|
| Address | 4000 Tyler St, Riverside, California |
| Phone Number | 9516874155 |
| Fax Number | 9516877448 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1063420255 |
|---|---|
| Provider Enumeration Date | 2006-08-03 |
| Last Updated Date | 2020-01-27 |
Provider Mailing Address Detail
| Address | 4000 Tyler St |
|---|---|
| City | Riverside |
| State | California (CA) |
| Post Code | 92503 |
| Phone Number | 9516874155 |
| Fax Number | 9516877448 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 39461 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code assigned to Stacy Mai Pham by the Centers for Medicare & Medicaid Services?
The Stacy Mai Pham has been issued the NPI (National Provider Identifier) 1063420255, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Stacy Mai Pham is physically located?
The Stacy Mai Pham is physically situated at the following address: 4000 Tyler St, Riverside, CA, 92503.
What is the Stacy Mai Pham's area of specialization and corresponding taxonomy classification?
The Stacy Mai Pham's specialty field is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1063420255 to Stacy Mai Pham?
The Stacy Mai Pham received its 1063420255 assignment from the Centers for Medicare & Medicaid Services on 2006-08-03.
When was the information regarding Stacy Mai Pham most recently updated?
The details pertaining to the Stacy Mai Pham, including its address, specialty, and other relevant information, were last refreshed on 2020-01-27.