Thanhgia Phung Prairie Medical Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THANHGIA PHUNG PRAIRIE MEDICAL GROUP

Practice address

15027 South Prairie Ave
Lawndale, CA 90260

Phone

(310) 970-9040

Fax

(310) 970-9201

NPI assigned

Mar 15, 2011

Organization subpart

No

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

Authorized official

Name

Thanh Gia Phung, M.D.NPI 1952315319

Title

Medical Director

Phone

(310) 970-9040

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thanh Gia Phung, M.D.

  • Diagnostic Radiology Physician
  • Tustin, CA
  • NPI 1952315319
  NPD (past) Authorized official

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1275832354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15027 SOUTH PRAIRIE AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "90260",
            "telephone_number": "310-970-9040",
            "fax_number": "310-970-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15027 SOUTH PRAIRIE AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "90260",
            "telephone_number": "310-970-9040",
            "fax_number": "310-970-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THANHGIA PHUNG PRAIRIE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "THANH",
        "authorized_official_middle_name": "GIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-970-9040",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Lawndale, CA
• Providers in Lawndale, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.