Emi Pham, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

57134 Issued in CA

Practice address

2251 N Harbor Blvd
Fullerton, CA 92835-2601

Phone

(714) 449-6230

Fax

(714) 449-1773

NPI assigned

Feb 27, 2019

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

Electronic endpoints 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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: epham1373728@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1932666815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23811 FORMELLO",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531843",
            "telephone_number": "714-487-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 N HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352601",
            "telephone_number": "714-449-6230",
            "fax_number": "714-449-1773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 E Chapman Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693204",
            "country_code": "US",
            "telephone_number": "714-633-1011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3240 Fort Rd",
            "address_purpose": "LOCATION",
            "city": "Toppenish",
            "state": "WA",
            "postal_code": "989489562",
            "country_code": "US",
            "telephone_number": "509-865-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "EMI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "57134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epham1373728@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5630 E Santa Ana Canyon Rd Ste 100",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Savanna Petty
• Pham and Sambangi Dental Corporation
• Danny D Pham
• Diana Pham
• Douglas Hiep Pham
• Heidi Thi Pham
• Jolene Nguyen Pham
• Kimberlee Khanh Pham
• Leslie Pham, MD
• Lisa Kim Pham, MSW

• Medical Physician Assistant in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.