T K Loan Pham MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A60749 Issued in CA

Legal business name

T K LOAN PHAM MD INC

Practice address

79440 Corporate Centre Dr.
Ste 117
La Quinta, CA 92253-7241

Phone

(760) 771-2626

Fax

(760) 771-2620

NPI assigned

Dec 22, 2008

Organization subpart

No

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

Authorized official

Name

Thi Kim Loan Pham, MD

Title

President/Owner

Phone

(760) 771-2626

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Thi Kim Loan Pham, MD

  • Internal Medicine Physician
  • La Quinta, CA
  • NPI 1649217217
  Medicare reassignment

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1457597411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13550",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922553550",
            "telephone_number": "760-771-2626",
            "fax_number": "760-771-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79440 CORPORATE CENTRE DR.",
            "address_2": "STE 117",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537241",
            "telephone_number": "760-771-2626",
            "fax_number": "760-771-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T K LOAN PHAM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "THI",
        "authorized_official_middle_name": "KIM LOAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "760-771-2626",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A60749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen R Stream, MD
• Calvin Sun, OD
• Bianca Sustaita
• Kamiren Swanson
• Peter Szolcsanyi, P.A.
• Rachel E. Taylor I, LMFC
• Nicole Thompson, LCSW
• Vanessa Arlene Thompson
• Kenneth Douglas Thrasher, D.O.
• Qing Julia Tian, MD

• Internal Medicine Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.