NPIMap

Organization Active NPI

Timothy a Pham, M.D., a Medical Corporation

  • Medical Specialty Clinic/Center
  • Arcadia, CA
National Provider Identifier
1073626776
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G77052 Issued in CA
Legal business name
TIMOTHY A PHAM, M.D., A MEDICAL CORPORATION
Practice address
301 W Huntington Dr
206
Arcadia, CA 91007-3462
Phone
(626) 461-0360
Fax
(626) 461-0371
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Dr. Timothy Anh Pham, M.D.NPI 1457549826
Title
President
Phone
(626) 461-0360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G77052 CA Primary

Addresses

Primary practice location

301 W Huntington Dr
206
Arcadia, CA 91007-3462

Mailing address

301 W Huntington Dr
206
Arcadia, CA 91007-3462
Phone (626) 461-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000398 CA Part B Supplier - Clinic/Group Practice 6507021052 Receives reassigned benefits from 1 practitioner
Practice locations: Arcadia, CA

National Provider Directory

National Provider Directory

Locations

301 W Huntington Dr
Ste 206
Arcadia, CA 91007
Phone (626) 461-0360

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1073626776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W HUNTINGTON DR",
            "address_2": "206",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910073462",
            "telephone_number": "626-461-0360",
            "fax_number": "626-461-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HUNTINGTON DR",
            "address_2": "206",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910073462",
            "telephone_number": "626-461-0360",
            "fax_number": "626-461-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY A PHAM, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-461-0360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G77052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.