Individual provider Active NPI

Duc Quy Pham, MD

  • Internal Medicine Physician
  • Mission Viejo, CA
National Provider Identifier
1689615221
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A62320 Issued in CA
Practice address
26800 Crown Valley Pkwy
Suite 315
Mission Viejo, CA 92691-6384
Phone
(949) 364-6000
Fax
(949) 364-1204
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A62320 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy
Suite 315
Mission Viejo, CA 92691-6384

Mailing address

26522 La Alameda
Suite 120
Mission Viejo, CA 92691-6330
Phone (949) 282-1600

Other identifiers 2

IdentifierTypeStateIssuer
00A623200MedicaidCA
GR0094890MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpham1373980@oc.providencedirect.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000413 CA Practitioner - Internal Medicine 0840218129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

200 W Ctr St Promenade
Anaheim, CA 92805-3960

24321 Avenida de la Carlota
Laguna Hills, CA 92653-3681
Phone (949) 204-3006

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

395 W Avenida Vista Hermosa
San Clemente, CA 92672-7720
Phone (949) 304-2117

Hospital & facility affiliations

  • Providence at Home With Compassus Home Health Orange County Home health agency, Anaheim, CA, CCN 057600
  • Providence at Home With Compassus Home Health, Orange County South Home health agency, Irvine, CA, CCN 058238
  • Hoag Home Health Home health agency, Newport Beach, CA, CCN 557412
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62320CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Moran Rowen and Dorsey Inc Past Accepting new patients
Universal Care Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
#1051182
Fullerton, CA 92835
Phone (714) 446-5200

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

26800 Crown Valley Pkwy
Ste 545
Mission Viejo, CA 92691
Phone (949) 364-1040

26800 Crown Valley Pkwy
Ste 315
Mission Viejo, CA 92691
Phone (949) 364-6001

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

395 W Avenida Vista Hermosa
Unit K
San Clemente, CA 92672
Phone (949) 304-2117

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dpham1373980@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1689615221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1600",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 315",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-6000",
            "fax_number": "949-364-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DUC",
        "middle_name": "QUY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A623200",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094890",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpham1373980@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.