| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ROGER VAN PHAM | 1295193746 | 2024-11-10 |
Roger Van Pham is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1295193746. Registration indicates Roger Van Pham is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Dentists-General (Dental Providers, Dentist) (Dental Providers, Dentist) (Dentist: General Practice, ) (Dental, ) (Dentist General Practice, Dental Providers) (Dentist, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:N |
| Entity Type | Individual |
| Provider Name | Dr. Roger Van Pham D.D.S. |
| Practice Office Address | 5603 AUBURN ST UNIT B BAKERSFIELD, CA US |
| Practice Office Telephone | 6613272189 |
| Practice Office Fax | 6613274350 |
| Mailing Address | 11510 HELIOTROPE CT BAKERSFIELD, CA 933118749 US |
| Business Telephone | 7146031795 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 1223G0001X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist: General Practice Dental Dentist General Practice Dental Providers Dentist | 100597
CA |