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Licensing details for: 434

Name: PHAM, CHIEU L

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Previous Names: PHAM, CHRIS

Address of Record

2015 Birch Rd
#103
CHULA VISTA CA 91915-2002
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Practice Location

110 Town Center Pkwy
#A
SANTEE CA 92071
SAN DIEGO county
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12395 El Camino Real
#312
SAN DIEGO CA 92130-3082
SAN DIEGO county
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2780 Cardinal Rd
#A
SAN DIEGO CA 92123-3353
SAN DIEGO county
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662 Dennery Rd
#103
SAN DIEGO CA 92154
SAN DIEGO county
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Issuance Date

October 24, 2025

Expiration Date

August 31, 2027

Current Date / Time

December 13, 2025
5:17:27 PM

License Relationships

PMS to DDS or OMS or SP

License/Registration Role: Pediatric Minimal Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: PHAM, CHIEU L

License/Registration Type: Dentist License

License Number: 52916 Primary Status: Current - Active

Address :
2015 Birch Rd Ste 103
CHULA VISTA CA 91915-2003
SAN DIEGO COUNTY

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