Michelle Pham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

33503 Issued in CA

Practice address

171 C Ave Ste B
Coronado, CA 92118-1423

Phone

(619) 625-1235

Fax

(619) 625-1238

NPI assigned

Jul 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Smit a. Patel O.D., and Irene Gendelman O.D., Apoc

  • Optometrist
  • Santee, CA
  • NPI 1316181563
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1629421995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 C AVE STE B",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181423",
            "telephone_number": "619-625-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 C AVE STE B",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181423",
            "telephone_number": "619-625-1235",
            "fax_number": "619-625-1238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9349 Mission Gorge Rd",
            "address_purpose": "LOCATION",
            "city": "Santee",
            "state": "CA",
            "postal_code": "920713886",
            "country_code": "US",
            "telephone_number": "619-448-2020",
            "fax_number": "619-448-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2146",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie R Perez, PMHNP
• Stephanie Perez
• Peter R. Kelly M.D. Inc
• Deanna Sue Petersen, LCSW
• Laura Norton Petrovich, MD
• Alexander Phillips, DDS
• Kelsey Coria Phillips, DDS
• Dolores Anne Phin, D.C.
• Markay Picou-McKinney, MA
• Jaime Pitner

• Optometrist in Coronado, CA
• Providers in Coronado, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.

Verify at the official NPI Registry.