Active NPI
D Q Pham Medical Corporation
- General Practice Physician
- Garden Grove, CA
National Provider Identifier
1770535841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A37427
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A62320 | CA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | A37427 | CA | |
| General Practice Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0094890 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
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.