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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LONG PHAM

Active Sole Proprietor

LONG PHAM is a Recreation Therapist healthcare provider located in EASTVALE, California. NPI 1962986042 is currently active in the NPPES registry. Verify at CMS.

Recreation Therapist · EASTVALE, CA

Registration Details

NPI Number
1962986042
Provider Type
Individual
Gender
Male
NPI Issued
Sep 24, 2018 (7.9252147487664 yrs)
Last Updated
Sep 24, 2018
License
29433 (CA)
Sole Proprietor
Yes

Practice Information

Address
7175 ENCLAVE DR
EASTVALE, CA, 928803828
Browse CA providers · Browse ZIP 92880
Phone
3187919853
Primary Specialty
Recreation Therapist
225800000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.