Active NPI
Ivy Pham, LACUPUNCTURIST
- Acupuncturist
- Monrovia, CA
National Provider Identifier
1700655396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 19782
- Practice address
- 1310 S Myrtle Ave
Monrovia, CA 91016-4151 - Phone
- (626) 740-7546
- NPI assigned
- Dec 25, 2023
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 19782 | CA | Primary |
Addresses
Primary practice location
1310 S Myrtle Ave
Monrovia, CA 91016-4151
Mailing address
225 S Ivy Ave # 2086
Monrovia, CA 91016-2835
Phone (626) 740-7546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19782 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734998400000",
"number": "1700655396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 S IVY AVE # 2086",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910162835",
"telephone_number": "626-740-7546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 S MYRTLE AVE",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910164151",
"telephone_number": "626-740-7546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "IVY",
"credential": "LACUPUNCTURIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-25",
"last_updated": "2024-12-24",
"certification_date": "2024-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "19782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.