Active NPI
Kevin Q Pham
- Pharmacist
- Garden Grove, CA
National Provider Identifier
1356904742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77286
- Practice address
- 13191 Hilton LN
Garden Grove, CA 92843-2222 - Phone
- (714) 363-6036
- NPI assigned
- Apr 21, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 77286 | CA | Primary |
Addresses
Primary practice location
13191 Hilton LN
Garden Grove, CA 92843-2222
Mailing address
13191 Hilton LN
Garden Grove, CA 92843-2222
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 |
|---|---|---|---|
| 77286 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555804800000",
"number": "1356904742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13191 HILTON LN",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928432222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13191 HILTON LN",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928432222",
"telephone_number": "714-363-6036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KEVIN",
"middle_name": "Q",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-21",
"last_updated": "2019-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "77286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.