Organization Active NPI

D Q Pham Medical Corporation

  • General Practice Physician
  • Garden Grove, CA
National Provider Identifier
1770535841
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A37427 Issued in CA
Legal business name
D Q PHAM MEDICAL CORPORATION
Practice address
14160 Brookhurst St
Garden Grove, CA 92843-4657
Phone
(714) 534-6911
Fax
(714) 534-0852
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Authorized official

Name
Mr. Dieu Quy Pham, MD
Title
President of DQ Pham Medical Corpor
Phone
(714) 534-6911

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A62320 CA
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X A37427 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A37427 CA Primary

Addresses

Primary practice location

14160 Brookhurst St
Garden Grove, CA 92843-4657

Mailing address

14160 Brookhurst St
Garden Grove, CA 92843-4657
Phone (714) 534-6911

Other identifiers 1

IdentifierTypeStateIssuer
GR0094890MedicaidCA

National Provider Directory

National Provider Directory

Locations

14160 Brookhurst St
Garden Grove, CA 92843
Phone (714) 534-6911

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1770535841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434657",
            "telephone_number": "714-534-6911",
            "fax_number": "714-534-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14160 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434657",
            "telephone_number": "714-534-6911",
            "fax_number": "714-534-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D Q PHAM MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "DIEU",
        "authorized_official_middle_name": "QUY",
        "authorized_official_title_or_position": "PRESIDENT OF DQ PHAM MEDICAL CORPOR",
        "authorized_official_telephone_number": "714-534-6911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62320",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A37427",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A37427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.