Individual provider Active NPI

Maggie Pham, D.O.

  • Obstetrics Physician
  • Pomona, CA
National Provider Identifier
1073907044
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
20A17125 Issued in CA
Practice address
160 E Artesia St Ste 330
Pomona, CA 91767-2922
Phone
(909) 622-5654
Fax
(909) 622-4914
NPI assigned
Mar 26, 2015
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 20A17125 CA Primary

Addresses

Primary practice location

160 E Artesia St Ste 330
Pomona, CA 91767-2922

Mailing address

160 E Artesia St Ste 330
Pomona, CA 91767-2922
Phone (909) 622-5654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719001975 CA Practitioner - Obstetrics/Gynecology 6800192766 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A17125CAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Femcare Medical Associates of Inland Valley, Inc a Prof Corp CurrentSince Oct 14, 2021 Accepting new patients
Maria Siu Apc CurrentSince Oct 14, 2021 Accepting new patients

Locations

756 N Euclid Ave
Ste A
Ontario, CA 91762
Phone (909) 395-0030

160 E Artesia St
Ste 330
Pomona, CA 91767
Phone (909) 622-5654

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1073907044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E ARTESIA ST STE 330",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672922",
            "telephone_number": "909-622-5654",
            "fax_number": "909-622-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ARTESIA ST STE 330",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672922",
            "telephone_number": "909-622-5654",
            "fax_number": "909-622-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MAGGIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "20A17125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.