Individual provider Active NPI

Nguyen Si Pham, M.D.

  • Otolaryngology Physician
  • Palo Alto, CA
National Provider Identifier
1861661373
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A102823 Issued in CA
Practice address
300 Pasteur Dr
Palo Alto, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A102823 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Palo Alto, CA 94305-2200

Mailing address

300 Pasteur Dr
Palo Alto, CA 94305-2200
Phone (650) 723-4000

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000701 CA Practitioner - Pediatric MedicinePractitioner - Otolaryngology 8325216278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Otolaryngology
Education
University of California, Irvine, California College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital of Orange CountyGroup PAC ID 6406944883, 70 clinicians

Practice addresses (Care Compare)

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (888) 770-2462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
102823CAMDDentist
A102823CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Orange County CurrentSince Oct 13, 2018 Accepting new patients
Surgicare of la Veta, LTD. PastSince Aug 23, 2013 Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Family Biocare LLC PastSince Mar 23, 2012 Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients

Locations

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1861661373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NGUYEN",
        "middle_name": "SI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A102823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.