Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

KIM NGAN PHAM
NPI 1265115406
Physician Assistant in Tustin, CA

Active since August 14, 2023PECOS Enrolled
13522 NEWPORT AVE STE 102, TUSTIN, CA 92780(714) 987-1121(551) 236-2481 Get Directions Write a Review

NPPES record last updated: July 18, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 18, 2026, Jul 10, 2026, Aug 14, 2023 (3 updates tracked since 2023).

About Kim Ngan Pham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM NGAN PHAM (NPI 1265115406) is an individual physician assistant in Tustin, California, licensed in California (1265115406) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265115406
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKIM NGAN PHAM
Location Address13522 NEWPORT AVE STE 102Tustin, CA 92780-3707
Mailing Address13522 Newport Ave Ste 102Tustin, CA 92780-3707 · (714) 987-1121 · Fax (551) 236-2481
Fax(551) 236-2481
Sole ProprietorYes
Enumeration DateAugust 14, 2023
Last NPPES UpdateJuly 18, 20263 updates tracked since enumeration
NPPES CertifiedJuly 18, 2026
NPI 1265115406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses Licensed in CA · 1265115406 Licensed in CA · MP0684921 Licensed in CA · 67708
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

13522 NEWPORT AVE STE 102, Tustin, CA 92780

Other Names 1

Other Name (5)Miss Kim Pham Pa-c

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kim Ngan Pham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92780 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Nurse Practitioner (Family)
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Nurse Practitioner (Gerontology)
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Internal Medicine (Pulmonary Disease)
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Internal Medicine
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Dentist
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Physical Medicine & Rehabilitation
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780
Physical Medicine & Rehabilitation
13522 NEWPORT AVE STE 102
TUSTIN, CA 92780

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265115406, enumerated as an "individual" on August 14, 2023.

The provider is located at 13522 NEWPORT AVE STE 102 TUSTIN, CA 92780 and the phone number is (714) 987-1121.

Physician Assistant with taxonomy code 363A00000X.