Organization Active NPI

Tuan a. Pham, MD, Inc

  • Cardiovascular Disease Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1215178736
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A62514 Issued in CA
Legal business name
TUAN A. PHAM, MD, INC
Practice address
9333 Baseline Rd
Suite 160
Rancho Cucamonga, CA 91730-1350
Phone
(909) 982-4116
Fax
(909) 982-4599
NPI assigned
Mar 12, 2009
Last updated
Jul 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Authorized official

Name
Tuan A Pham, MDNPI 1134163793
Title
President
Phone
(909) 941-4777

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A62514 CA
Cardiovascular Disease Physician 207RC0000X A62514 CA Primary

Addresses

Primary practice location

9333 Baseline Rd
Suite 160
Rancho Cucamonga, CA 91730-1350

Mailing address

9333 Baseline Road
Suite 160
Ranco Cucamonga, CA 91730-1350
Phone (909) 982-4116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091212000039 CA Part B Supplier - Clinic/Group Practice 5597805135 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

9333 Base Line Rd
Ste 130
Rancho Cucamonga, CA 91730

9333 Base Line Rd
Ste 160
Rch Cucamonga, CA 91730
Phone (909) 285-6717

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1215178736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 BASELINE ROAD",
            "address_2": "SUITE 160",
            "city": "RANCO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301350",
            "telephone_number": "909-982-4116",
            "fax_number": "909-941-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 BASELINE RD",
            "address_2": "SUITE 160",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301350",
            "telephone_number": "909-982-4116",
            "fax_number": "909-982-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUAN A. PHAM, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TUAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-941-4777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A62514",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A62514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.