Active NPI
Trung Tan Pham
- Physical Therapist
- Elk Grove, CA
National Provider Identifier
1427456615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26845
- Practice address
- 8257 Hopewell Dr
Elk Grove, CA 95757-6287 - Phone
- (916) 686-6802
- NPI assigned
- Dec 20, 2014
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT26845 | CA | Primary |
Addresses
Primary practice location
8257 Hopewell Dr
Elk Grove, CA 95757-6287
Mailing address
8257 Hopewell Dr
Elk Grove, CA 95757-6287
Phone (916) 686-6802
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT26845 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419033600000",
"number": "1427456615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8257 HOPEWELL DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957576287",
"telephone_number": "916-686-6802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8257 HOPEWELL DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957576287",
"telephone_number": "916-686-6802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "TRUNG",
"middle_name": "TAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-20",
"last_updated": "2014-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT26845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.