Ryan Duy Pham

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56054 Issued in CA

Practice address

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505

Phone

(949) 760-9222

Fax

(949) 579-2906

NPI assigned

Oct 8, 2018

Sex

Male

Sole proprietor

No

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

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marque Medical Clinic, Inc.Group PAC ID 9537345665, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Marque Medical Clinic, Inc.

  dba Marque Urgent Care, Inc.-Newport Beach

  • Urgent Care Clinic/Center
  • Newport Beach, CA
  • NPI 1538466107
  Medicare reassignment Care Compare group
• Marque Medical Clinic, Inc

  • Urgent Care Clinic/Center
  • Chula Vista, CA
  • NPI 1164303442
  NPD

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1245705086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11744 SUMMERWOOD CT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082668",
            "telephone_number": "714-401-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-760-9222",
            "fax_number": "949-579-2906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11744 Summerwood Ct",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927082668",
            "country_code": "US",
            "telephone_number": "714-401-8579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "RYAN",
        "middle_name": "DUY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ken Vinh Pham, DPT
• Larry D Pham, M.D.
• Marcie Beasley Pham, MA
• Nguyen Phuong Tra Pham
• Quynh Pham
• Thang Pham, MD
• To Pham, MD
• Alan Khanh Phan, PHARM.D.
• Cu Ngoc Phan, M.D.
• Jennifer Phan

• Physician Assistant in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.