Active NPI
Paul Pham
- Adult Psychiatric/Mental Health Registered Nurse
- San Diego, CA
National Provider Identifier
1760045264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 95132872
- Practice address
- 3853 Rosecrans St
San Diego, CA 92110-3115 - Phone
- (619) 692-8232
- NPI assigned
- Apr 19, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 95132872 | CA | Primary |
Addresses
Primary practice location
3853 Rosecrans St
San Diego, CA 92110-3115
Mailing address
10631 Dabney Dr Apt 50
San Diego, CA 92126-2545
Phone (858) 449-2530
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 |
|---|---|---|---|
| 95132872 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1760045264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10631 DABNEY DR APT 50",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921262545",
"telephone_number": "858-449-2530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3853 ROSECRANS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103115",
"telephone_number": "619-692-8232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-19",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "CA",
"license": "95132872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.