Dzung Anh Pham, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6269 Issued in CA

Practice address

2940 Nau Ave
Tustin, CA 92782-3377

Phone

(949) 654-8455

Fax

(888) 805-6665

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Dzung Pham, DO Medical Corporation

  • Family Medicine Physician
  • Tustin, CA
  • NPI 1477183077
  NPD Authorized official
• Irvine Village Urgent Care

  • Primary Care Clinic/Center
  • Irvine, CA
  • NPI 1609325588
  NPD (past) Authorized official
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1790749653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 NAU AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927823377",
            "telephone_number": "949-654-8455",
            "fax_number": "888-805-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 NAU AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927823377",
            "telephone_number": "949-654-8455",
            "fax_number": "888-805-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DZUNG",
        "middle_name": "ANH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Performance Medical Inc
• Judy Jean Permejo
• Pham Consulting, LLC
• Angela Diemanh Pham
• David Duy Pham
• Katie Pham, PHARMD
• Kendall Pham
• Kim Ngan Pham
• Lorna Pham, PSY.D
• Mary Pham, PHARM.D

• Family Medicine Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.