Individual provider · Type 1 NPI
Khoa Pham, PA-C
Medical Physician Assistant · Apo, AP
NPI number
1740865765
Active
Practice location
Unit 15092
Apo, AP 96224-5092
Mailing address
111050 Mount Belvedere Blvd
Fort Drum, NY 13602
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1178809 |
Medical Physician Assistant: Definition to come...
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About NPI 1740865765
Khoa Pham, PA-C's National Provider Identifier is 1740865765, issued on Mar 11, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Apo, AP. The record was last updated on Oct 13, 2025.