Krystal H Pham MD, LTD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

12284 Issued in NV

Legal business name

KRYSTAL H PHAM MD, LTD

Practice address

3040 W Charleston Blvd
Las Vegas, NV 89102-1944

Phone

(702) 477-0101

Fax

(702) 477-0254

NPI assigned

Nov 8, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krystal Hanhtran Pham, M.D.

Title

President

Phone

(702) 477-0101

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1831379650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021944",
            "telephone_number": "702-477-0101",
            "fax_number": "702-477-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021944",
            "telephone_number": "702-477-0101",
            "fax_number": "702-477-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRYSTAL H PHAM MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "HANHTRAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-477-0101",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NV",
            "license": "12284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Henry Krygiell, RPH
• Gabriella Krygier
• Leinani Krygier
• Lenise Kryk, M.ED., BCBA
• Sarah Kryst, PA-C
• Triston Olivia Krysztof, M.S., LMFT
• KS Behavioral LLC
• KSM Corporate Holdings (Nevada Mobility)
• KSM Corporate Holdings LLC (Nevada Mobility)
• Ksweetshaircompany

• Medical Specialty Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Medical Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.