Tony Dieu Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12348T Issued in CA

Practice address

6755 Mira Mesa Blvd
Suite 141
San Diego, CA 92121-4392

Phone

(858) 535-8282

Fax

(858) 535-0537

NPI assigned

Nov 10, 2005

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Tony D Pham OD Inc

  • Optometrist
  • San Diego, CA
  • NPI 1760672315
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1841271434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 MIRA MESA BLVD",
            "address_2": "SUITE 141",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214392",
            "telephone_number": "858-535-8282",
            "fax_number": "858-535-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 MIRA MESA BLVD",
            "address_2": "SUITE 141",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214392",
            "telephone_number": "858-535-8282",
            "fax_number": "858-535-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TONY",
        "middle_name": "DIEU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12348T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760672315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Pham
• Thong Pham
• Tien Duc Pham, DPT
• Tiffany Thienthao Pham, MD
• Tiffany Trinh Pham
• Tony Huy Pham, M.D.
• Truc Thuy Pham
• Truce Duong Thanh Pham
• Tuongvy Pham
• Van N Pham

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.