Ken Vinh Pham, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT296455 Issued in CA

Practice address

3300 Irvine Ave Ste 130
Newport Beach, CA 92660-3119

Phone

(949) 271-0053

Fax

(949) 271-9453

NPI assigned

Apr 3, 2019

Last updated

Jun 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1164984613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216735",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 IRVINE AVE STE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603119",
            "telephone_number": "949-271-0053",
            "fax_number": "949-271-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KEN",
        "middle_name": "VINH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT296455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babak Pezeshki, M.D.
• Chambrielle Thuy Pham, MFT
• David Q Pham, PHARM.D.
• Hali Hoang Pham, FNP
• Kathleen Pham, R.D.
• Larry D Pham, M.D.
• Marcie Beasley Pham, MA
• Nguyen Phuong Tra Pham
• Quynh Pham
• Ryan Duy Pham

• Physical Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.