Individual provider Active NPI

Anh Thu Pham

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1144049800
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NPF95027036 Issued in CA
Practice address
9778 Katella Ave Ste 106
Anaheim, CA 92804-6446
Phone
(714) 867-6594
Fax
(714) 486-1120
NPI assigned
Oct 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NPF95027036 CA Primary

Addresses

Primary practice location

9778 Katella Ave Ste 106
Anaheim, CA 92804-6446

Mailing address

5802 Abraham Ave
Westminster, CA 92683-2806
Phone (714) 791-4539

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108003609 CA Order and Referring Only - Nurse Practitioner 7416481742

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9024 Bolsa Ave
Westminster, CA 92683-5531

9126 Valley Blvd
Suite B
Rosemead, CA 91770-1987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NPF95027036CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rize Hospice Family Medicine PastSince Oct 13, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1144049800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 ABRAHAM AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926832806",
            "telephone_number": "714-791-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9778 KATELLA AVE STE 106",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928046446",
            "telephone_number": "714-867-6594",
            "fax_number": "714-486-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANH THU",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NPF95027036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.