Active NPI
An Thi Pham, M.D.
- Pediatrics Physician
- San Jose, CA
National Provider Identifier
1578597241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A37379
- Practice address
- 1693 Flanigan Dr
Suite # 101
San Jose, CA 95121-1683 - Phone
- (408) 274-1339
- Fax
- (408) 274-1350
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A37379 | CA | Primary |
Addresses
Primary practice location
1693 Flanigan Dr
Suite # 101
San Jose, CA 95121-1683
Mailing address
1693 Flanigan Dr
Suite # 101
San Jose, CA 95121-1683
Phone (408) 274-1339
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126000580 | CA | Order and Referring Only - Pediatric Medicine | 0840593836 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37379 | CA | MD | Dental Hygienist |
| A37379 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578597241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1693 FLANIGAN DR",
"address_2": "SUITE # 101",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951211683",
"telephone_number": "408-274-1339",
"fax_number": "408-274-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1693 FLANIGAN DR",
"address_2": "SUITE # 101",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951211683",
"telephone_number": "408-274-1339",
"fax_number": "408-274-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "AN",
"middle_name": "THI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A37379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.