Individual provider Active NPI

Truc N Pham, D.C.

  • Rehabilitation Chiropractor
  • San Jose, CA
National Provider Identifier
1578645826
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC26797 Issued in CA
Practice address
639 Tully Rd Ste G
San Jose, CA 95111-1000
Phone
(408) 947-8684
Fax
(408) 947-0321
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC26797 CA Primary

Addresses

Primary practice location

639 Tully Rd Ste G
San Jose, CA 95111-1000

Mailing address

639 Tully Rd Ste G
San Jose, CA 95111-1000
Phone (408) 947-8684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000273 CA Practitioner - Chiropractic 5991874679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1914 Aborn Rd
San Jose, CA 95121-1581
Phone (408) 947-8684

Merit-based Incentive Payment System (MIPS)

Final score
23.12 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26797CAMDRehabilitation Chiropractor
26797CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pham and Nong Professional Chiropractic Corporation CurrentSince Apr 15, 2008 Accepting new patients
Gia-Hung Phan Chiropractic Inc PastSince Aug 31, 2018 Accepting new patients

Locations

1914 Aborn Rd
San Jose, CA 95121
Phone (408) 947-8684

1340 Tully Rd
Ste 308
San Jose, CA 95122
Phone (408) 528-9000

639 Tully Rd
Ste G
San Jose, CA 95111
Phone (408) 947-8684

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1578645826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 TULLY RD STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111000",
            "telephone_number": "408-947-8684",
            "fax_number": "408-947-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 TULLY RD STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111000",
            "telephone_number": "408-947-8684",
            "fax_number": "408-947-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TRUC",
        "middle_name": "N",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC26797",
            "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 Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.