Organization Active NPI

Cao Van Pham M D Inc

  • Cardiovascular Disease Physician
  • Huntington Beach, CA
National Provider Identifier
1518289503
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CAO VAN PHAM M D INC
Practice address
17742 Beach Blvd
Suite #230
Huntington Beach, CA 92647-6835
Phone
(714) 848-0032
Fax
(714) 847-4442
NPI assigned
Feb 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Cao Van Pham, M.D.NPI 1225095631
Title
Owner/President of Corp.
Phone
(714) 848-0032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

17742 Beach Blvd
Suite #230
Huntington Beach, CA 92647-6835

Mailing address

17742 Beach Blvd
Suite #230
Huntington Beach, CA 92647-6835
Phone (714) 848-0032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100318000509 CA Part B Supplier - Clinic/Group Practice 4688709488 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory

Locations

17742 Beach Blvd
Ste 230
Huntington Beach, CA 92647
Phone (714) 848-0032

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1518289503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD",
            "address_2": "SUITE #230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476835",
            "telephone_number": "714-848-0032",
            "fax_number": "714-847-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD",
            "address_2": "SUITE #230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476835",
            "telephone_number": "714-848-0032",
            "fax_number": "714-847-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAO VAN PHAM M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "CAO",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT OF CORP.",
        "authorized_official_telephone_number": "714-848-0032",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.