Kristin Vo Pham, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT297779 Issued in CA

Practice address

485 E 17TH St Ste 650
Costa Mesa, CA 92627-4706

Phone

(949) 722-7374

NPI assigned

Dec 13, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1972141505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10622 BOLSA AVE APT 6",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435202",
            "telephone_number": "714-489-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 E 17TH ST STE 650",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274706",
            "telephone_number": "949-722-7374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6865 Alton Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926183740",
            "country_code": "US",
            "telephone_number": "949-679-2933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Corporate Plaza Dr # 113",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926607985",
            "country_code": "US",
            "telephone_number": "949-722-5054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KRISTIN",
        "middle_name": "VO",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gibson Pham
• Heather Pham
• John Duy Pham
• Judy Pham, RN
• Julie Kimchi Pham
• Lam Linh Pham
• Lien D Pham, MS
• Phoebe Tu-Phi Pham
• Thomas Pham
• Timmy Pham

• Physical Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.