Individual provider Active NPI

Quan Minh Pham, D.D.S

  • Dentist
  • Arvin, CA
National Provider Identifier
1932235652
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50175 Issued in CA
Practice address
734 Bear Mountain Blvd
Arvin, CA 93203-1414
Phone
(702) 327-6685
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50175 CA Primary

Addresses

Primary practice location

734 Bear Mountain Blvd
Arvin, CA 93203-1414

Mailing address

310 N Olympia PL
Anaheim, CA 92806-3631
Phone (702) 327-6685

Other identifiers 1

IdentifierTypeStateIssuer
002202095MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Interoperability endpoints

  • Direct secure messaging: qpham@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1932235652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N OLYMPIA PL",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928063631",
            "telephone_number": "702-327-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 BEAR MOUNTAIN BLVD",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "932031414",
            "telephone_number": "702-327-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "QUAN",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002202095",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.