| NPI | 1750082780 |
|---|---|
| Other Name | PETER PHAM NURSING CORPORATION |
| Doing Business As | BLACK ONYX |
| Entity Type | Organization |
| Authorized Contact | PETER PHAM Mr 714-410-6588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-11-17 |