Active NPI
Hien Van Pham, DC
- Chiropractor
- Garden Grove, CA
National Provider Identifier
1013104595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 30504
- Practice address
- 12800 Garden Grove Blvd Ste a
Garden Grove, CA 92843-2008 - Phone
- (714) 467-0293
- Fax
- (714) 467-0298
- NPI assigned
- Sep 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 30504 | CA | Primary |
| Rehabilitation Chiropractor | 111NR0400X | 30504 | CA |
Addresses
Primary practice location
12800 Garden Grove Blvd Ste a
Garden Grove, CA 92843-2008
Mailing address
12800 Garden Grove Blvd Ste a
Garden Grove, CA 92843-2008
Phone (714) 467-0293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30504 | CA | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1013104595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12800 GARDEN GROVE BLVD STE A",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928432008",
"telephone_number": "714-467-0293",
"fax_number": "714-467-0298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12800 GARDEN GROVE BLVD STE A",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928432008",
"telephone_number": "714-467-0293",
"fax_number": "714-467-0298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "HIEN",
"middle_name": "VAN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-28",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "30504",
"primary": true
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "30504",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.