Active NPI
Gemie N Pham, O.D.
- Optometrist
- Fountain Valley, CA
National Provider Identifier
1265677363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13553
- Practice address
- 17099 Brookhurst St
Fountain Valley, CA 92708-3601 - Phone
- (714) 968-4269
- Fax
- (714) 968-5352
- NPI assigned
- Dec 4, 2008
- Last updated
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 13553 | CA | Primary |
Addresses
Primary practice location
17099 Brookhurst St
Fountain Valley, CA 92708-3601
Mailing address
11872 Garnet Cir
Garden Grove, CA 92845-1210
Phone (714) 856-4592
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13553 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gemie N Pham, OD Professional Corporation | Optometrist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Fountain Valley, CA
- NPI 1942559273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346371200000",
"number": "1265677363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11872 GARNET CIR",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928451210",
"telephone_number": "714-856-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17099 BROOKHURST ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927083601",
"telephone_number": "714-968-4269",
"fax_number": "714-968-5352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "GEMIE",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-04",
"last_updated": "2012-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.