Individual provider Active NPI

Mai N Pham, MD

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1124014345
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A78321 Issued in CA
Practice address
1221 E Spruce Ave
Fresno, CA 93720-3374
Phone
(559) 450-5777
Fax
(559) 449-2654
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A78321 CA Primary

Addresses

Primary practice location

1221 E Spruce Ave
Fresno, CA 93720-3374

Mailing address

1221 E Spruce Ave
Fresno, CA 93720-3374
Phone (559) 450-5777

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
I20131101000867 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9931334786

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78321CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124014345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203374",
            "telephone_number": "559-450-5777",
            "fax_number": "559-449-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203374",
            "telephone_number": "559-450-5777",
            "fax_number": "559-449-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MAI",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.