Mychelle N. Pham, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A81905 Issued in CA

Practice address

455 S Main St
Orange, CA 92868-3835

Phone

(714) 532-8620

Fax

(714) 289-4072

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Subspecialty Faculty, Inc.

  • Pediatrics Physician
  • Orange, CA
  • NPI 1790850279
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1770679508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-289-4511",
            "fax_number": "714-204-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-532-8620",
            "fax_number": "714-289-4072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2212 E 4th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053872",
            "country_code": "US",
            "telephone_number": "714-288-3230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5630 E Santa Ana Canyon Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928073122",
            "country_code": "US",
            "telephone_number": "714-257-6170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MYCHELLE",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A81905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A819050",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "W16177",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "HW16177",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linh Thi-Thanh Pham, MD
• Lisa Pham, NP
• Luyen Dinh Pham, MA MFT
• Madalyn Ninhcat Pham
• Meghan Dao Pham
• Nghia Trung Pham, MD
• Ngocdiep Claudette Pham, NP
• Nguyen Phuong Quyn Pham
• Nguyen Tuong Vy Pham
• Peter Pham, NP

• Pediatrics Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.