Individual provider Active NPI

Quynh A Pham, MD

  • Pediatrics Physician
  • Santa Ana, CA
National Provider Identifier
1720615644
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
183364 Issued in CA
Practice address
1400 N Main St
Santa Ana, CA 92701-2304
Phone
(888) 499-9303
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1720615644 CA
Pediatrics Physician 208000000X 183364 CA Primary

Addresses

Primary practice location

1400 N Main St
Santa Ana, CA 92701-2304

Mailing address

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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
I20210810004104 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012311228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1720615644CAMDPediatrics Physician
183364CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine PastSince Mar 1, 2020 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1720615644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012304",
            "telephone_number": "888-499-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "QUYNH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "1720615644",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "183364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.