Pham, Connie
Pham, Connie is an individual health care provider with primary practice located at 1190 Baker St Ste 100 , Costa Mesa CA 92626-4105. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pham, Connie can be contacted via phone (949) 791-3250.Contact Information
Primary practice address
1190 Baker St Ste 100
Costa Mesa CA 92626-4105
Phone: (949) 791-3250
Fax: (949) 791-3261
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS0021627 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20A23711 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | S1221 | Texas |
Profile Details
| NPI number | 1073967584 |
|---|---|
| LBN Legal business name | Pham, Connie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2016 |
| Last updated | Nov 3rd, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073967584 | NPPES |
| Other | 831947 | MEDICARE | |
| Other | P02284117 | MEDICARE | |
| MEDICAID | 400345101 | MEDICARE |
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