Nguyen-Phuong Dinh Pham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A105426 Issued in CA

Practice address

16854 Ivy Ave
Fontana, CA 92335-1504

Phone

(909) 580-1000

NPI assigned

Nov 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians

County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023
  Medicare reassignment Care Compare group NPD
• Vituity Physician Services PC

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1124884176
  Medicare reassignment Care Compare group NPD
• Vituity Healthcare Services PC

  • Family Medicine Physician
  • Colton, CA
  • NPI 1700642758
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of San Bernardino

  • General Acute Care Hospital
  • Colton, CA
  • NPI 1720158009
  Care Compare affiliation

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

{
    "created_epoch": "1227916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227916800000",
    "number": "1558516823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N LINDEN AVE",
            "address_2": "#59",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765400",
            "telephone_number": "714-399-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16854 IVY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351504",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NGUYEN-PHUONG",
        "middle_name": "DINH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-29",
        "last_updated": "2008-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey C. Petrilla, MD
• Khue N. Pham, MD
• Loan Trung Pham, MD
• Luan Pham, DPM
• My-Linh Kieu Quang Pham, MD
• Sani Hanh Pham, PHARM, D.
• Thang Van Pham, DO
• Thien-Huong Michelle Pham
• Vincent Pham
• Diane Phan, DDS

• Family Medicine Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.