Tam Nguyen Thi Pham MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G81625 Issued in CA

Legal business name

TAM NGUYEN THI PHAM MD INC

Doing business as

Lighthouse Anesthesia Medical Group

Practice address

12900A Garden Grove Blvd
Ste 122
Garden Grove, CA 92843

Phone

(714) 636-0342

Fax

(714) 636-0391

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Tam Nguyen Thi Pham

Title

President

Phone

(714) 636-0342

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lighthouse Anesthesia Medical Group Doing business as

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1356417752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92842",
            "telephone_number": "714-636-0342",
            "fax_number": "714-636-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900A GARDEN GROVE BLVD",
            "address_2": "STE 122",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-636-0342",
            "fax_number": "714-636-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAM NGUYEN THI PHAM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TAM NGUYEN",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-636-0342"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G81625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G816250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00205661",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Anesthesia Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Todd Takasaki, RPH
• Khaldoun Takwa
• Abraham Talavera
• Desiree Nicole Talmadge
• Tam K Nguyen Medical Professional Corp
• Tam Pham DDS Inc
• Tam Ton Dental, Inc
• Kyle Tam
• Yvonne Tam, DDS
• Tan Khuu Dental Corporation

• Anesthesiology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.