Individual provider Active NPI

Peter Son Pham, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1972580868
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G86169 Issued in CA
Practice address
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Phone
(213) 977-2121
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G86169 CA Primary

Addresses

Primary practice location

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Mailing address

PO Box 25033
Santa Ana, CA 92799-5033
Phone (714) 347-1000

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
I20060112001040 CA Practitioner - Anesthesiology 8123041332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Virginia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

11411 Brookshire Ave
Downey, CA 90241-5026
Phone (562) 789-5456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86169CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians Anesthesiology CurrentSince Dec 1, 2023 Accepting new patients
Pih Health Physicians CurrentSince Dec 1, 2023 Accepting new patients
Samaritan Anesthesiology Medical Group Anesthesiology CurrentSince Nov 1, 2006 Accepting new patients
Washington Hospital Center Corp Anesthesiology Past Accepting new patients

Locations

11411 Brookshire Ave
Downey, CA 90241
Phone (562) 862-4566

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

Dept LA 24632
Pasadena, CA 91185

210 N Tustin Ave
Santa Ana, CA 92705
Phone (714) 347-1000

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1972580868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25033",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927995033",
            "telephone_number": "714-347-1000",
            "fax_number": "714-347-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PETER",
        "middle_name": "SON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G86169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.